汶川地震所致精神伤害对院前急救的影响
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摘要
目的研究汶川地震后精神伤害对院前急救的影响。方法对2010年10月1日-2012年10月31日院前急救患者的地震后家庭成员状况、精神伤害情况及病情程度进行回顾性病例对照分析。共有446例患者纳入研究,男278例,女188例;年龄(41.4±2.8)岁。依据家庭成员遇难状况分3组,A组(家庭成员在地震中遇难)25例,B组(家庭成员在地震中受伤,无遇难情况)127例,C组(地震家庭成员完好)314例。结果各组患者最常见的精神伤害状况是焦虑(A组96.0%,B组71.7%,C组40.8%)、过度警惕(A组92.0%,B组70.9%,C组50.0%),差异有统计学意义(P<0.001)。A组患者要求到上级医院继续治疗率较高(A组56.0%,B组39.4%,C组8.9%),组间差异有统计学意义(P<0.001)。结论地震给人们的精神创伤较重,至今仍然普遍存在,并对患者的就医活动产生影响。提示在北川县院前急救工作中需要考虑患者的精神伤害情况。
Objective To study the impact of posttraumatic stress disorder(PTSD) on pre-hospital service after Wenchuan Earthquake.Methods Retrospective case-control study was carried out on family members status,mental injury,and disease severity of pre-hospital emergency patients after Wenchuan Earthquake between October 1st,2010 and October 31st,2012.A total of 446 cases were included in this study,including 278 males and 133 females with an average age of(41.4 ± 2.8)years old.The patients were divided into three groups according to the injury and death status of their family members.Group A(all family members were dead) had 25 patients;group B(family members were injured,but not dead) had 127 patients;And 314 patients were assigned into group C(no injury or death occurred to the family members).Results Two most common mental injuries were anxiety(group A,96.0%;group B,71.7%;group C,40.8%) and excessive vigilance(group A,92.0%;group B,70.9%;group C,50.0%),and the differences among the three groups were significant(P < 0.01).Group A had more patients asking for treatment from higher-level hospitals than the other two groups(group A,56.0%;group B,39.4%;group C,8.9%),and the differences were also significant(P < 0.01).Conclusions Mental injury is still very widespread and severe after Wenchuan earthquake.This affects patients' medical treatment activities.That means the mental injury status should be considered in the progress of pre-hospital emergency treatment in Beichuan Country.
Objective To study the impact of posttraumatic stress disorder(PTSD) on pre-hospital service after Wenchuan Earthquake.Methods Retrospective case-control study was carried out on family members status,mental injury,and disease severity of pre-hospital emergency patients after Wenchuan Earthquake between October 1st,2010 and October 31st,2012.A total of 446 cases were included in this study,including 278 males and 133 females with an average age of(41.4 ± 2.8)years old.The patients were divided into three groups according to the injury and death status of their family members.Group A(all family members were dead) had 25 patients;group B(family members were injured,but not dead) had 127 patients;And 314 patients were assigned into group C(no injury or death occurred to the family members).Results Two most common mental injuries were anxiety(group A,96.0%;group B,71.7%;group C,40.8%) and excessive vigilance(group A,92.0%;group B,70.9%;group C,50.0%),and the differences among the three groups were significant(P < 0.01).Group A had more patients asking for treatment from higher-level hospitals than the other two groups(group A,56.0%;group B,39.4%;group C,8.9%),and the differences were also significant(P < 0.01).Conclusions Mental injury is still very widespread and severe after Wenchuan earthquake.This affects patients' medical treatment activities.That means the mental injury status should be considered in the progress of pre-hospital emergency treatment in Beichuan Country.
引文
[1]万建辉.北川新县城昨整体移交[N/OL].长江日报,2010-09-26(12).http://cjmp.cnhan.com/cjrb/html/2010-09/26/content_4130009.htm.
[2]胡海,唐时元,曹钰,等.浅论“5.12”汶川地震直升飞机大批量转运伤病员的医疗管理[J].中国急救复苏与灾害医学杂志,2009,4(4):206-208.
[3]杜鑫淼,胡海,曹钰,等.汶川地震中早期评估一线医院危重伤患者死亡风险的多因素分析[J].灾害医学与救援,2012,1(4):216-219.
[4]刘晓,王家同.汶川地震的应激障碍研究[J].军医进修学院学报,2011,32(7):734-735.
[5]胡海,何庆.汶川地震中直升机转运伤员760例[J].中华急诊医学杂志,2008,17(9):908-910.
[6]胡海,何亚荣,曹钰,等.浅析日本灾难救援体系以及对我国建立灾难救援体系的借鉴[J].中国急救复苏与灾害医学杂志,2012,7(10):893-896.
[7]Ba o lu M,Salcio lu E,Livanou M.Traumatic stress responses in earthquake survivors in Turkey[J].J Trauma Stress,2002,15(4):269-276.
[8]Chen CH,Tan HK,Liao LR,et al.Long-term psychological outcome of 1999 Taiwan earthquake survivors:a survey of a high-risk sample with property damage[J].Compr Psychiatry,2007,48(3):269-275.
[9]王丽萍,张本,姜涛,等.唐山大地震所致慢性创伤后应激障碍临床研究[J].中国心理卫生杂志,2005,19(8):517-520.
[10]康霞,王凤英,谢国省.震后康复期青少年创伤后精神障碍的预防[J].华西医学,2009,24(3):555-557.
[11]黄静,吴悦维.地震灾区青少年伤员创伤后应激障碍及心理、药物干预[J].中国医药指南,2008,6(10):6-7.
[12]李静,李小麟,王丹,等.汶川大地震受伤人员心理干预理论框架与初步实践[J].华西医学,2008,23(4):834-835.
[13]胡海,杜鑫淼,曹钰,等.医学生灾害医学救援培训需求调查分析[J].灾害医学与救援,2012,1(4):220-222.
[14]Yamashita J,Shigemura J.The great East Japan earthquake,tsunami,and fukushima daiichi nuclear power plant accident:a triple disaster affecting the mental health of the country[J].Psychiatr Clin North Am,2013,36(3):351-370.
[15]Zhang Z,Wang W,Shi Z,et al.Mental health problems among the survivors in the hard-hit areas of the Yushu earthquake[J].PLoS One,2012,7(10):e46449.
[16]Zhou X,Kang L,Sun X,et al.Risk factors of mental illness among adult survivors after the Wenchuan earthquake[J].Soc Psychiatry Psychiatr Epidemiol,2013,48(6):907-915.
[2]胡海,唐时元,曹钰,等.浅论“5.12”汶川地震直升飞机大批量转运伤病员的医疗管理[J].中国急救复苏与灾害医学杂志,2009,4(4):206-208.
[3]杜鑫淼,胡海,曹钰,等.汶川地震中早期评估一线医院危重伤患者死亡风险的多因素分析[J].灾害医学与救援,2012,1(4):216-219.
[4]刘晓,王家同.汶川地震的应激障碍研究[J].军医进修学院学报,2011,32(7):734-735.
[5]胡海,何庆.汶川地震中直升机转运伤员760例[J].中华急诊医学杂志,2008,17(9):908-910.
[6]胡海,何亚荣,曹钰,等.浅析日本灾难救援体系以及对我国建立灾难救援体系的借鉴[J].中国急救复苏与灾害医学杂志,2012,7(10):893-896.
[7]Ba o lu M,Salcio lu E,Livanou M.Traumatic stress responses in earthquake survivors in Turkey[J].J Trauma Stress,2002,15(4):269-276.
[8]Chen CH,Tan HK,Liao LR,et al.Long-term psychological outcome of 1999 Taiwan earthquake survivors:a survey of a high-risk sample with property damage[J].Compr Psychiatry,2007,48(3):269-275.
[9]王丽萍,张本,姜涛,等.唐山大地震所致慢性创伤后应激障碍临床研究[J].中国心理卫生杂志,2005,19(8):517-520.
[10]康霞,王凤英,谢国省.震后康复期青少年创伤后精神障碍的预防[J].华西医学,2009,24(3):555-557.
[11]黄静,吴悦维.地震灾区青少年伤员创伤后应激障碍及心理、药物干预[J].中国医药指南,2008,6(10):6-7.
[12]李静,李小麟,王丹,等.汶川大地震受伤人员心理干预理论框架与初步实践[J].华西医学,2008,23(4):834-835.
[13]胡海,杜鑫淼,曹钰,等.医学生灾害医学救援培训需求调查分析[J].灾害医学与救援,2012,1(4):220-222.
[14]Yamashita J,Shigemura J.The great East Japan earthquake,tsunami,and fukushima daiichi nuclear power plant accident:a triple disaster affecting the mental health of the country[J].Psychiatr Clin North Am,2013,36(3):351-370.
[15]Zhang Z,Wang W,Shi Z,et al.Mental health problems among the survivors in the hard-hit areas of the Yushu earthquake[J].PLoS One,2012,7(10):e46449.
[16]Zhou X,Kang L,Sun X,et al.Risk factors of mental illness among adult survivors after the Wenchuan earthquake[J].Soc Psychiatry Psychiatr Epidemiol,2013,48(6):907-915.
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