• 四川大學(xué)(成都，610041) 1 華西臨床醫(yī)學(xué)院，2 華西醫(yī)院心理衛(wèi)生中心;

【摘要】　目的　 了解和分析玉樹(shù)地震傷員急性應(yīng)激期睡眠問(wèn)題。　方法　 2010年4月，對(duì)90例玉樹(shù)地震傷員的急性應(yīng)激反應(yīng)采用創(chuàng)傷后應(yīng)激障礙癥狀清單平民版(PCL-C)17項(xiàng)量表進(jìn)行篩查評(píng)估，并應(yīng)用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。　結(jié)果　 在PCL-C 17個(gè)條目中，提示睡眠障礙的條目2和條目13發(fā)生率分別為61.10%、63.30%，分別排列第5位、第3位，其得分分別與PCL-C總得分、閃回癥狀得分、回避癥狀得分及高警覺(jué)性癥狀得分均呈正相關(guān)(P值均 lt;0.01)。　結(jié)論　 睡眠障礙是地震傷員急性應(yīng)激反應(yīng)中的常見(jiàn)問(wèn)題，需高度重視，并進(jìn)行積極有效的處理。
【Abstract】　Objective　 To learn and analyze the sleep disorders in acute stress of the wounded persons in Yushu earthquake.　Methods　 The acute stress reaction of 90 wounded persons in Yushu earthquake were screened with post-traumatic stress disorder (PTSD) Checklist-Civilian (PCL-C) version-17 in April 2010. Sleep disorders were statistically analyzed with SPSS 17.0.　Results　 In the 17 items of PCL-C, the incidences of the second and the thirteenth item which were related to sleep disorders were respectively 61.10% ranking at the fifth and 63.30% ranking at the third. Both scores of these two items had significant positive correlation with the total score of PCL-C and the scores of the flashback symptom, the avoidance symptom and the heightened alertness symptom (P lt;0.01).　Conclusion　 Sleep disorder is a common problem in acute stress reaction of wounded persons in earthquakes, which needs high attention to be treated positively.

引用本文： 朱仕超,李小麟,黃雪花,陶慶蘭,吳學(xué)華,蒙雅靜,劉晴曉,許家軍,李娜. 玉樹(shù)地震傷員急性應(yīng)激期睡眠問(wèn)題分析. 華西醫(yī)學(xué), 2011, 26(2): 195-197. doi: 復(fù)制

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  2. 2. 　張本, 許瑞芬, 于振劍, 等. 汶川大地震急性應(yīng)激障礙檢出率及相關(guān)因素的調(diào)查研究[J]. 中國(guó)健康心理學(xué)雜志, 2009, 17(10): 1158-1160.
  3. 3. 　曾嶸, 胡風(fēng)云, 姚世昌. 汶川地震傷員在綜合醫(yī)院救治時(shí)心理狀況的調(diào)查分析[J]. 山西職工醫(yī)學(xué)院學(xué)報(bào), 2010, 20(1): 8-11.
  4. 4. 　吳坎坎, 張雨青, 張寧, 等. 震后極重災(zāi)區(qū)幸存者創(chuàng)傷后應(yīng)激障礙癥狀的結(jié)構(gòu)探析[J]. 中國(guó)臨床心理學(xué)雜志, 2010, 18(1): 60-62.
  5. 5. 　American Psychiatric Association. Diagnostic and statistic manual of mental disorders[M]. 4th ed. Washington DC: American Psychiatric Press, 2000.
  6. 6. 　Schreuder BJ, van Egmond M, Kleijn WC, et al. Daily reports of posttraumatic nightmares and anxiety dreams in Dutch war victims[J]. J Anxiety Disord, 1998, 12(6): 511-524.
  7. 7. 　Zayfert C, de Viva JC. Residual insomnia following cognitive behavioral therapy for PTSD[J]. J Trauma Stress, 2004, 17(1): 69-73.
  8. 8. 　Spoormaker Ⅵ, Montgomery P. Disturbed sleep in post-traumatic stress disorder: Secondary symptom or core feature?[J]. Sleep Med Rev, 2008, 12(3): 169-184.
  9. 9. 　National Institutes of Health. Consensus development conference statement: the treatment of sleep disorders of older people[J]. Sleep, 1991, 14(2): 169-177.
  10. 10. 　Morin CM, Hauri PJ, Espie CA, et al. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review[J]. Sleep, 1999, 22(8): 1134-1156.
  11. 11. 　Raskind MA, Peskind ER, Kanter ED, et al. Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study[J]. Am J Psychiatry, 2003, 160(2): 371-373.
  12. 12. 　Hauri PJ. Case studies in insomnia[M]. New York: Plenum Press, 1991: 19-84.
  13. 13. 　Spielman AJ, Saskin P, Thorpy MJ. Treatment of chronic insomnia by restriction of time in bed[J]. Sleep, 1987, 10(1): 45-56.