重型颅脑损伤病人创伤后应激障碍的风险因素分析

目的 探讨重型颅脑损伤病人并发创伤后应激障碍（PTSD）的危险因素。方法 回顾性分析2020年1月至2022年2月收治的110例重型颅脑损伤的临床资料。出院前采用PTSD自评量表（PTSD-SS）评估PTSD情况，总分≥50分表示存在PTSD。结果 110例PTSD-SS评分总分（49.64±7.29）分，其中≥50分52例（47.27%）。多因素logistic回归分析显示，女性、低龄、家庭人均月收入低、非亲属照顾、无经济赔偿、合并颅内感染为重型颅脑损伤并发PTSD的独立影响因素（P<0.05）。根据多因素logistic回归分析结果构建PTSD列线图显示一致性指数为0.886，预测PTSD具有较高的应用价值。结论 重症颅脑损伤病人并发PTSD的风险较高，女性、年轻病人、收入低、非亲属照顾、无经济赔偿、合并颅内感染等因素会增加PTSD发生风险，临床应密切关注，识别PTSD风险因素，并给予有效的防治措施降低PTSD发生率。

Risk factors for post-traumatic stress disorder in patients with severe traumatic brain injury

Objective To explore the risk factors of post-traumatic stress disorder (PTSD) in patients with severe traumatic brain injury (TBI). Methods The clinical data of 110 patients with severe TBI who were admitted to our hospital from January 2020 to February 2022 were retrospectively analyzed. PTSD was assessed according to the PTSD Self-Rating Scale (PTSD-SS) before discharge, with a total score ≥50 indicating the PTSD. Results The total PTSD-SS score of 110 patients was 49.64±7.29. Fifty-two patients (47.27%) had PTSD. Multivariate logistic regression analysis showed that female, young age, low family income, non-relative care, no economic compensation, and complicated with intracranial infection were independent risk factors for PTSD in patients with severe TBI (P<0.05). According to the results of multiple logistic regression analysis, the nomogram of the PTSD was constructed, and the consistency index was 0.886, which has a high application value in predicting PTSD. Conclusions Patients with severe TBI have a higher risk of PTSD. Female patients, young patients, low income, non-family care, no financial compensation, and intracranial infection can increase the risk of PTSD. Clinical attention should be paid to identify the risk factors of PTSD and effective prevention, and treatment measures should be given to reduce the incidence of PTSD.