山西'3·28'王家岭煤矿透水事故获救矿工创伤性应激反应分析

摘要

目的 分析矿难后创伤性应激障碍(PTSD)的发生情况及影响因素.方法 采用修订的事件影响量表(IES-R),社会支持评定量表(SSRS),艾森克人格问卷(EPQ),应对方式问卷对81例幸存矿工在事故后1周进行临床评估.结果 ①在81例获救矿工中可疑PTSD检出率为35.8%,其中闯入症状发生率为41.3%,回避症状发生率为30.8%,高警觉症状发生率为27.7%.②相关分析显示,幻想与IES-R总分呈正相关(P<0.01),求助、客观支持与IES-R总分呈负相关(P<0.01),EPQ的E量表得分与IES-R总分及闯入因子得分、逃避因子得分呈负相关(P<0.05).③多元回归结果显示,幻想、求助、客观支持得分进入回归方程,入选变量可以解释IES-R得分变异量的73.3%.结论 ①在本次矿难中可疑PTSD发生率较高,闯入症状出现的频率最高,应引起足够的重视.②幻想是发生PTSD的危险因素,求助及客观支持是PTSD保护因素,可以预防PTSD的发生,在就医诊疗过程中建立良好的护患关系是PTSD干预的基础.%Objective To explore the occurrence of post-traumatic stress disorder( PTSD ) and its influential factors in survivors of the coal mine accident. Methods Impact of events scale-revised ( IES-R ), social support rating scale ( SSRS ),Eysenck personality questionnaire ( EPQ ), and coping style questionnaire were used to estimate the symptoms of 81 survivors after the coal mine accident for one week. Results ①The prevalence rate of suspected PTSD among 81 survivors was 35.8％. The prevalence rate of intrusion was 41.3％ ,the prevalence rate of avoidance was 30.8％, and the prevalence rate of hyper-arousal reactions was 27.7％. ②IES-R total score was positively correlated with fantasy ( P ＜0.01 ),but negatively correlated with seeking help and objective support ( P ＜0.01 ).E score of EPQ was negatively correlated with IES-R score, intrusion score, avoidance score ( P ＜ 0.05 ). ③Fantasy, seeking help,objective support were predictors for PTSD, and the predictive rate was 73.3％. Conclusion ①The prevalence of suspected PTSD among survivors from coal mining accident is high, especially intrusion, which suggests that psychological or medication interventions is necessary. ②Fantasy is a risk factor for PTSD, and seeking help,objective support are protective factors. Early nursing intervention can prevent the occurrence of PTSD and improve quality of life of patients.