摘要
目的 探讨车祸伤后病人应激障碍的发生率、症状特征以及相关的影响因素。方法 对 10 5例车祸伤的病人采用PTSD -SS等量表分别于创伤后、创伤后 3个月及 1年进行评定 ,并用CCMD -Ⅲ中有关急性应激障碍和创伤后应激障碍诊断标准进行再诊断。结果 3个月及 12个月时创伤后应激障碍的发生率分别为 35 2 3%,33 33%。其症状主要分为 3类 :反复重现创伤体验 (侵入性思维 ,噩梦 ,闪回 ,想象或记忆 ) ;持续性的警觉性增高 (惊跳反映 ,精力不集中 ,易激惹 ,失眠 ,警觉性高 ) ;持续回避或反应麻木 (情感平淡或隔离 ,兴趣丧失 ,回避有关创伤的任何活动、场景、人物或者话题 )。相关的影响因素有受伤的严重程度、事故的组别如司机或摩托车手或乘客、工作情况不良、既往乘车经历如患者在以往乘车时经常害怕出现车祸、既往曾有过车祸伤史、女性、对事故现场的记忆尤其清晰、既往就有焦虑倾向、对事故的态度较消极以及事故处理和法律问题处理不当等。结论 车祸伤后应激障碍并不少见 ,且具有一定的症状 ,骨科医师在治疗骨科疾病的同时也应该重视PTSD的发生及其防治 ,以保证病人较早恢复身心健康 ,提高病人的生活质量。
Objective To study the incidence,character and relative factors of PTSD after traffic accident.Methods 105 patients were tested with PTSD-SS after traffic accident,3 month and 12 month respectively,then re-diagnosed by CCMD-Ⅲ.Results The incidence of PTSD 3 month and 12 month after traffic accident were 35.23% and 33.33% respectively.The clinical presentation of PTSD is characterized by moderate-to-severe symptoms in 3 separate domains:reexperiencing (intrusive thoughts,nightmares,flashback,images,or memories);increased arousal (startle reactions,poor concentration,irritability,insomnia,and hypervigilance);and emotional numbing and avoidance(flattened affect or detachment,loss of interest and motivation,and avoidance of any activity,place,person,or topic associated with the trauma).The relative factors were severity of traumatic,group,work,experience of past traffic traumatic history,attitude to traumatic,gender,memory of traffic accident,et al.Conclusion PTSD is common in the patients after traffic accident,and it has its characteristic symptoms.Early prevent is more important.
出处
《中国全科医学》
CAS
CSCD
2003年第10期840-842,共3页
Chinese General Practice
