毒蛇咬伤患者创伤后应激障碍现状及影响因素

Current Situation and Influencing Factors of Post-Traumatic Stress Disorder in Patients Bitten by Venomous Snakes

摘要: 目的：探讨毒蛇咬伤患者创伤后应激障碍(PTSD)现状及相关影响因素。方法：2023年4月至2024年10月，采用便利抽样法抽取衡阳市某三甲医院收治的123例符合纳排标准的毒蛇咬伤患者作为研究对象。采用一般资料调查表、修订版创伤后应激障碍症状筛查量表、数字评定量表(NRS)、修订版Wong-Baker面部表情疼痛评估量表(FPS-R)及日常生活评定量表(ADL)对其进行调查。结果：毒蛇咬伤患者中PTSD患病率为17.9%。经单因素分析及多元线性回归分析显示：职业、医保类型、肢体肿胀程度、院前措施、后遗症的存在及日常生活能力是毒蛇咬伤患者患有PTSD的主要因素(P < 0.05)，可解释创伤后应激障碍水平68.9%的变异度。结论：医护人员需对毒蛇咬伤患者开展早期创伤后应激障碍针对性心理干预，针对不同患病群体制定不同干预方案，并开展研究进一步探讨改善毒蛇咬伤创伤后应激障碍的策略。

Abstract: Objective: To explore the status and related factors of post-traumatic stress disorder (PTSD) in patients bitten by venomous snakes. Methods: From April 2023 to October 2024, a convenience sampling method was employed to enroll 123 eligible snakebite patients treated at a tertiary hospital in Hengyang City as research subjects. The study utilized standardized assessment tools including a general information questionnaire, revised Post-Traumatic Stress Disorder (PTSD) symptom screening scale, numeric rating scale (NRS), revised Wong-Baker Facial Pain Rating Scale (FPS-R), and Activities of Daily Living (ADL) assessment scale for comprehensive evaluation. Results: PTSD prevalence among patients bitten by venomous snakes was 17.9%. Multivariate linear regression analysis and univariate factor analysis revealed that occupation, type of health insurance, degree of limb swelling, pre-hospital measures, presence of sequelae, and daily living abilities were the main factors contributing to PTSD development (P < 0.05), explaining 68.9% of the variance in post-traumatic stress disorder levels. Conclusion: Medical staff should carry out early psychological intervention for patients bitten by venomous snakes, formulate different intervention plans according to different patient groups, and carry out further research to explore strategies to improve post-traumatic stress disorder in snake bites.