创伤性脑损伤患者创伤后成长与创伤后应激障碍的调查研究

目的分析创伤性脑损伤（TBI）患者创伤后成长（PTG）与创伤后应激障碍（PTSD）的现况及其影响因素。 方法通过便利抽样的方法，选取首都医科大学附属北京天坛医院神经外科自2019年7月至2020年1月就诊的85例TBI患者为研究对象，使用创伤后成长评定量表（PTGI）、创伤后应激障碍量表平民版（PCL-C）调查TBI患者的PTG水平、PTSD情况，并进一步分析TBI患者PTG的影响因素。 结果TBI患者PTGI总分为（58.41±23.05）分，处于低水平。PCL-C得分为（36.18±16.52）分，PCL-C阳性症状检出率为41.2%。多元线性回归分析结果显示，文化程度、性格类型、社会支持、警觉性增高、创伤再体验是TBI患者PTG的影响因素。TBI患者文化水平低、外向型性格、社会支持水平越高其PTG水平越高。TBI事件后警觉性反应低者，PTG水平较高，创伤再体验症状促进PTG的发生。 结论TBI患者创伤后早期同时出现PTG及PTSD，通过调动患者个体内部因素及外在社会联系等方面积极因素，可能提高患者PTG水平。

Investigation of post-traumatic growth and post-traumatic stress disorder in patients with traumatic brain injury

ObjectiveTo investigate the status of post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) in patients with traumatic brain injury (TBI), and to explore the potential influencing factors of PTG. MethodsBy convenient sampling method, 85 patients with TBI in Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University from July 2019 to January 2020 was selected as the research objects. Post-traumatic growth inventory (PTGI) and post-traumatic stress disorder check-list-civilian version (PCL-C) scales were used to investigate the level of PTG and the symptoms of PTSD in patients with TBI, and the influencing factors of PTG were further analyzed. ResultsThe total PTGI score of TBI patients was 58.41±23.05, which was at a low level. The PCL-C score was 36.18±16.52, and the detection rate of PCL-C positive symptoms was 41.2%. Multiple linear regression analysis showed that educational level, personality type, social support, increased alertness and trauma re-experience were the influencing factors of PTG in TBI patients. TBI patients who have lower levels of education, extroverted personality, and higher levels of social support will have a higher PTGI. Those with low alert response after TBI events have higher levels of PTG, and re-experience symptoms of trauma promote PTG. ConclusionPatients with TBI experience PTG and PTSD at the same time, mobilize internal factors and social connections will likely promote patients’PTG levels.