CAJ | 학술논문

目的：调查芦山地震住院伤员急性应激障碍（ ASD）和创伤后应激障碍（ PTSD）的状况及其影响因素。方法对四川省人民医院接收的69例芦山地震灾区伤员在入院一周内使用ASD量表、抑郁-焦虑-压力自评量表、认知情绪调节量表及自编的一般情况量表进行评估，在地震后40天电话回访到其中的52名伤员进行PTSD评估。将性别、年龄、职业、文化程度、受伤程度、是否参与救援工作、是否有家庭成员受伤或死亡等22个项目与ASD的四个症状进行差异性分析，并将ASD对PTSD的预测作用以及 PTSD 影响因素作多元线性回归分析。结果 ASD 检出率为42.03％， ASD 对 PTSD 的预测率为55.88％，PTSD的检出率为65.38％。性别、康复情况等7个因素进入PTSD回归方程。 ASD的过激和再现症状对PTSD的解释量为36.3％。多元线性回归分析显示性别、康复情况、ASD再现和过激症状、焦虑症状、认知情绪策略中的灾难化和理性分析对PTSD有影响（B＝－0.046、－0.286、1.676、0.282、0.291、0.129和－1.566，均P＜0.001）。结论地震住院伤员PTSD检出率高，未检出ASD的患者40天后可能出现PTSD。性别、康复情况、ASD症状、焦虑症状、认知情绪策略会影响住院伤员患创伤后应激障碍。
목적：조사호산지진주원상원급성응격장애（ ASD）화창상후응격장애（ PTSD）적상황급기영향인소。방법대사천성인민의원접수적69례호산지진재구상원재입원일주내사용ASD량표、억욱-초필-압력자평량표、인지정서조절량표급자편적일반정황량표진행평고，재지진후40천전화회방도기중적52명상원진행PTSD평고。장성별、년령、직업、문화정도、수상정도、시부삼여구원공작、시부유가정성원수상혹사망등22개항목여ASD적사개증상진행차이성분석，병장ASD대PTSD적예측작용이급 PTSD 영향인소작다원선성회귀분석。결과 ASD 검출솔위42.03％， ASD 대 PTSD 적예측솔위55.88％，PTSD적검출솔위65.38％。성별、강복정황등7개인소진입PTSD회귀방정。 ASD적과격화재현증상대PTSD적해석량위36.3％。다원선성회귀분석현시성별、강복정황、ASD재현화과격증상、초필증상、인지정서책략중적재난화화이성분석대PTSD유영향（B＝－0.046、－0.286、1.676、0.282、0.291、0.129화－1.566，균P＜0.001）。결론지진주원상원PTSD검출솔고，미검출ASD적환자40천후가능출현PTSD。성별、강복정황、ASD증상、초필증상、인지정서책략회영향주원상원환창상후응격장애。
Objective To investigate the status of acute stress disorder( ASD) and posttraumatic stress disorder( PTSD) in hos-pitalized victims from Lushan earthquake and their influencing factors.Methods Acute stress disorder scale, DASS-21, CERQ-C, SPAN-C and general condition survey of 69 hospitalized earthquake victims in our hospital were evaluated within one week after admis-sion.In the 40 days after the earthquake,a return visit to evaluate PTSD was completed in 52 victims.Possible 22 influence factors such as sex,age,occupation,education level,injury degree,whether to participate in the rescue work and whether there were family members injured or killed were analyzed with four symptoms of ASD.At the same time,prediction effect of ASD on PTSD and PTSD influence factors were analyzed by using multivariate linear regression analysis.Results The incidence rate of ASD was 42.03%.The prediction rate of ASD on PTSD was 55.88%.The incidence of PTSD was 65.38%.Seven factors, such as gender, rehabilitation, etc.entered PTSD regression equation.ASD's excesses and reproductive symptoms could explain 36.3%of PTSD.The multivariate linear regression analysis showed that ASD's excesses and reproductive symptoms,anxiety symptoms,catastrophe and rational analysis of cognitive emo-tion strategy had an effect on PTSD(B=-0.046、-0.286、1.676、0.282、0.291、0.129、-1.566,P <0.001).Conclusion The inci-dence of ASD is high.The hospitalized victims with non-ASD are likely to be PTSD after 40 days.Gender,recovery,the symptoms of ASD and cognitive emotion regulation strategy can affect the prediction of PTSD.