| 李娟,张志坚,田黎,等.非创伤脓毒症幸存康复病人急性应激障碍的危险因素分析[J].安徽医药,2021,25(2):276-279. |
| 非创伤脓毒症幸存康复病人急性应激障碍的危险因素分析 |
| Risk factors of acute stress disorder in survivors of non-trauma associated sepsis |
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| DOI：10.3969/j.issn.1009-6469.2021.02.016. |
| 中文关键词: 脓毒症 非创伤性 急性应激障碍 危险因素 斯坦福急性应激反应问卷 |
| 英文关键词: Sepsis Non-trauma Acute stress disorder Risk factor Stanford acute stress reaction questionnaire |
| 基金项目:重庆市卫生和计划生育委员会项目( 2017ZBXM023，ZY201703036)；重庆市巴南区社会事业科技计划项目( 2016-6) |
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| 中文摘要: |
| 目的探讨非创伤脓毒症幸存康复病人急性应激障碍( ASD)的危险因素。方法选择 2017年 1月至 2019年 1月重庆市巴南区人民医院收治的非创伤脓毒症幸存康复病人 512例，使用斯坦福急性应激反应问卷( SASRQ)对病人进行 ASD评定，同时记录病人的临床资料及治疗情况，分析非创伤脓毒症病人 ASD的危险因素。结果根据 SASRQ评估，符合 DSM-Ⅳ诊断标准，本组病人中 81例合并 ASD，发生率为 15.82%。ASD组病人序贯器官衰竭评估( SOFA)评分 ≥6分、急性生理功能和慢性健康状况评分系统 Ⅱ(APACHE Ⅱ)评分 ≥15分、急性呼吸窘迫综合征( ARDS)、急性肾损伤( AKI)、有创机械通气、血液净化、住 ICU、院内感染、阿片类镇痛药及苯二氮?类镇静剂使用病人均高于非 ASD病人，差异有统计学意义( χ2值分别为 122.543、101.388、61.172、57.539、107.416、21.429、67.314、16.394、33.638、64.721，P < 0.001)。 Logistic回归分析显示， APACHE Ⅱ评分 ≥ 15分( OR = 5.432，95%CI:1.033～25.497)、 SOFA评分 ≥分( OR = 7.479，95%CI:1.345～31.451)、有创机械通气( OR =19.173，95%CI6.302～51.183)、住 ICU(OR=16.545，95%CI:2.739～41.258)是非创伤脓毒症病人 ASD的独立危险因素。结论 APACHE Ⅱ评分 ≥ 15分、 SOFA评分 ≥6分、有创机械通气及入住 ICU是非创伤性脓毒症病人急性应激障碍的独立危险因素。 |
| 英文摘要: |
| Objective To explore the risk factors of acute stress disorder(ASD)in survivors of non-trauma associated sepsis.Meth? ods A total of 512 patients with non-trauma associated sepsis admitted to People’s Hospital of Ba’nan District of Chongqing fromJanuary 2017 to January 2019 were enrolled in this study. All subjects were assessed on ASD with Stanford acute stress reaction questionnaire(SASRQ)，and the clinical data and treatment status during hospitalization were collected to analyze the risk factors of ASD. Results According to the score of SASRQ，compliance with DSM-Ⅳ diagnostic criteria，81 cases were complicated with ASD，with an incidence rate of 15.82%. There were more ASD patients with Sequential Organ Failure Assessment(SOFA)score≥6，Acute Physiology and Chronic Health Evaluation Scoring System Ⅱ(APACHE Ⅱ)score≥15，acute respiratory distress syndrome(ARDS)，acute kidney injury(AKI)，invasive mechanical ventilation，continuous hemofiltration，ICU admission，nosocomial infections，use of opioid analgesics and benzodiazepam were than non-ASD patients. The differences were statistically significant(χ2=122.543，101.388，61.172，57.539，107.416，21.429，67.314，16.394，33.638，64.721，P < 0.001). Logistic regression analysis showed that APACHE Ⅱ score≥15(OR = 5.432，95%CI:1.033～25.497)，SOFA score≥6(OR = 7.479，95%CI:1.345～31.451)，invasive mechanical ventilation(OR = 19.173，95%CI:6.302～51.183)， and ICU admission(OR = 16.545，95%CI:2.739～41.258)were independent risk factors for ASD.Conclusion APACHE Ⅱ score ≥ 15，SOFA score≥6，invasive mechanical ventilation and ICU admission were independent risk factors for ASD among patients with non-trauma associated sepsis. |
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