昭通地震救援军队医务人员创伤后应激障碍的研究

摘要

目的：探讨云南昭通地震救援军队医务人员的心理应激状况及对睡眠影响。方法以云南昭通地震后3个月抽取参与云南昭通地震救援的57名军队医务人员为研究对象，采用创伤后应激障碍检查量表（PCL－C）、症状自评量表（SCL－90）、应对方式问卷（CSQ）、艾森克个性问卷（EPQ）、社会支持评定量表（ SSRS）、匹兹堡睡眠质量指数量表（ PSQI）进行问卷调查。结果57名军队救援医护人员PCL－C量表结果显示，11名得分为50～85分，表明有较明显创伤后应激障碍（ PTSD）症状，诊断为PTSD。对照组为PCL－C量表PTSD筛查阴性的46名军队医护人员，军队救援医务人员中PTSD组睡眠障碍的发生率显著高于对照组（ P＜0.05）；PTSD组中症状自评量表躯体化症状、忧郁、焦虑3个因子得分高于对照组，差异有统计学意义（P＜0.05）；PTSD组中艾森克个性问卷神经质因子得分高于对照组，差异有统计学意义（P＜0.05）；PTSD组心理干预后PCL－C得分明显低于心理干预前，差异性显著（ P＜0.05）。结论参与地震救援的军队医务人员易出现PTSD症状，而PTSD加重了医务人员睡眠障碍的发生，通过及时的心理及药物治疗后，PTSD症状可缓解。%Objective To study the occurrence of post-traumatic stress disorder( PTSD) and its effect on sleep quality of the military medical staff after Zhaotong earthquake.Methods Military medical staff who had par-ticipated in the earthquake relief were selected as research object 3 months after Zhaotong earthquake.The ques-tionnaire survey was carried out by using PCL-C,SCL-90,CSQ,EPQ,SSRS and PSQI.Results The result of PCL-C scale showed that 11 military medical staff scored 50-85 points,indicating obvious PTSD symptoms and diagnosed as PTSD.In the control group was 46 military medical staff who were not diagnosed as PTSD by using PCL-C.A-mong the medical staff taking part in the military rescue,the ratio of the medical staff who had sleep disorders in those diagnosed as PTSD was significantly higher than that in the control group(P<0.05).The scores of factors as somatic symptoms,depression and anxiety measured by SCL-90 in PTSD group were significantly higher than those without PTSD symptoms(P<0.05).The score of neuroticism measured by EPQ in PTSD group was significantly higher than those without PTSD symptoms(P<0.05).The score of PCL-C in PTSD group after psychological inter-vention was significantly lower than that before psychological intervention(P<0.05).Conclusion The military medical staff involved in earthquake relief are prone to PTSD symptoms,and PTSD increases the occurrence of sleep disorders in the medical staff.Through timely psychological and drug treatment,PTSD symptoms can be relieved.