创伤性骨折患者创伤后应激障碍发生情况及影响因素分析

doi:10.12183/j.scjpm.2025.1337

摘要/Abstract

摘要： 目的探讨创伤性骨折患者发生创伤后应激障碍（PTSD）的变化情况,并分析相关影响因素。方法采用便利抽样法,对2021年7月至2024年6月泰州市第二人民医院骨科住院治疗的创伤性骨折患者进行创伤后应激障碍及相关因素的问卷调查。采用描述流行病学分析方法对PTSD发生情况进行分析,并采用单、多因素分析方法对PTSD影响因素进行分析。结果本研究共纳入1 040例创伤性骨折患者进行调查,伤后1个月,PTSD患者116例,发生率为11.15%;伤后3个月,PTSD患者69例,发生率为6.63%;伤后6个月,PTSD患者22例,发生率为2.12%。经多因素logistic回归分析,创伤后1个月,女性（OR=1.648）、家庭平均月收入<2 000元（OR=2.128）、致伤原因为交通事故（OR=3.294）、重伤（OR=2.159）、危重伤（OR=2.715）、睡眠质量差（OR=1.532）、家庭关怀严重障碍（OR=2.723）、预计康复结局为残疾（OR=3.234）是创伤性骨折患者发生PTSD的影响因素（均P<0.05）;创伤后3个月,女性（OR=2.602）、重伤（OR=2.316）、危重伤（OR=4.552）、睡眠质量差（OR=2.645）、预计康复结局为残疾（OR=6.194）是创伤性骨折患者发生PTSD的影响因素（均P<0.05）;创伤后6个月,睡眠质量差（OR=4.267）、预计康复结局为残疾（OR=4.745）是创伤性骨折患者发生PTSD的影响因素（均P<0.01）。结论创伤性骨折患者PTSD发生情况呈现动态变化,在创伤初期PTSD发生率最高。在伤后不同时间点,患者PTSD发生的影响因素存在一定差异,其中睡眠质量及预计康复结局残疾是长期影响PTSD发生的主要危险因素。

关键词: 创伤性骨折, 创伤后应激障碍, 流行病学, 睡眠障碍, 康复预后

Abstract: Objective To investigate the incidence of post-traumatic stress disorder (PTSD) among patients with traumatic fractures and to analyze its associated risk factors. Methods A convenience sampling method was employed to recruit patients with traumatic fractures admitted to the orthopedic department of The Second People's Hospital of Taizhou between July 2021 and June 2024. A questionnaire-based survey was administered. The incidence of PTSD was analyzed using descriptive epidemiological methods, while univariate and multivariate analyses were utilized to identify its determinants. Results A total of 1 040 patients with traumatic fractures were included in the investigation. The incidence of PTSD was 11.15% (116 cases) at 1 month post-injury, decreasing to 6.63% (69 cases) at 3 months, and further to 2.12% (22 cases) at 6 months. Multivariate logistic regression analysis revealed that at 1 month post-injury, the significant risk factors for PTSD were female gender (OR=1.648), average monthly household income <2 000 RMB (OR=2.128), traffic accident as the cause of injury (OR=3.294), severe injury (OR=2.159), critical injury (OR=2.715), poor sleep quality (OR=1.532), severely deficient family support (OR=2.723), and an expected rehabilitation outcome of disability (OR=3.234) (all P<0.05). At 3 months post-injury, significant predictors included female gender (OR=2.602), severe injury (OR=2.316), critical injury (OR=4.552), poor sleep quality (OR=2.645), and an expected rehabilitation outcome of disability (OR=6.194) (all P<0.05). At 6 months post-injury, poor sleep quality (OR=4.267) and an expected rehabilitation outcome of disability (OR=4.745) remained significant risk factors (all P<0.01). Conclusions The incidence of PTSD in patients with traumatic fractures demonstrates a dynamic temporal pattern, with the highest prevalence observed in the initial post-traumatic period. The factors influencing PTSD onset vary at different time points post-injury. Notably, poor sleep quality and an anticipated outcome of disability are primary, persistent risk factors for the long-term development of PTSD.

Key words: Traumatic fracture, Post-traumatic stress disorder (PTSD), Epidemiology, Sleep disturbance, Rehabilitation prognosis

中图分类号:

R749.5

李素华, 卞月琴, 韩萍萍. 创伤性骨折患者创伤后应激障碍发生情况及影响因素分析[J]. 华南预防医学, 2025, 51(12): 1337-1342.

Li Suhua, Bian Yueqin, Han Pingping. Incidence and influencing factors of post traumatic stress disorder among patients with traumatic fracture[J]. South China Journal of Preventive Medicine, 2025, 51(12): 1337-1342.

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