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目的探讨口腔颌面骨折后患者对植入内固定物后产生创伤后应激障碍(PTSD)危险因素分析。方法选140例颌面部创伤病人,在全麻手术植入内固定器械前和手术后,分别用刘贤臣等编制的自评量表(PTSD-SS)进行评价。结果骨折内固定器械植入在两处以上有119人,其中108人总分在25分以上,59人在50分以上,一处骨折植入内固定器械的患者总分均未高过25分,男性69人高于25分,女性39人高于25分,140例骨折患者中本科以上学历者40人,仅有8人高于25分,产生术后相关并发症的31例均高于25分,108人高于25分的病例中,72例拆除钛板后其中有69例低于25分。结论颌面部骨折植入内固定器械后产生PTSD的潜在危险因素包括创伤性事件、骨折发生的部位以及植入内固定的数量、个体易感因素、学历(或者为学习经历),产生术后相关并发症,即术后切口感染,钛板排异,咬合错乱,面部骨折错位愈合,均对患者造成不同程度的PTSD,但术后拆除钛板可有效的缓解PTSD的发生。
Objective To investigate the risk factors of posttraumatic stress disorder (PTSD) in patients with oral and maxillofacial fractures implanted with internal fixators. Methods One hundred and forty maxillofacial traumatic patients were selected and evaluated by PTSD-SS before and after implantation of internal fixation device under general anesthesia. Results There were 119 patients with fractures implanted in more than two places, of whom 108 had a total score of 25 or more and 59 had a score of 50 or more. The total score of the patients with a fracture implanted with internal fixation devices was not higher than 25 , 69 were higher than 25 men and 39 women were higher than 25 points, 140 patients with fracture or more undergraduate 40, only 8 were higher than 25 points, resulting in postoperative complications were higher than the 31 cases Of 25 cases and 108 cases of patients with a score above 25, 69 of 72 cases were below 25 points after removal of titanium plate. Conclusions Potential risk factors for PTSD after maxillofacial fracture implantation include traumatic events, the site of fractures and the number of implants, individual predisposition factors, academic qualifications (or learning experience), postoperative The related complications, such as postoperative incision infection, abnormal titanium plate, occlusion disorder, and facial fracture dislocation healing, all caused varying degrees of PTSD in patients. However, the removal of titanium plate after operation can effectively relieve the occurrence of PTSD.