目的：了解芦山地震伤员的急性应激障碍发生情况及其影响因素，为进一步开展灾后心理卫生服务提供依据。方法选取2013年4月因芦山地震就诊于四川省某三级甲等医院伤员168名，采用自行设计一般资料调查表和创伤后应激障碍症状清单平民版量表进行调查，以了解芦山地震伤员的急性应激障碍发生情况。结果168名地震伤员急性应激障碍总分为（29.51±10.85）分，发生急性应激障碍38名（22.6%），未发生急性应激障碍130名（77.4%）。再体验症状阳性75名（44.6%），回避麻木症状阳性16名（9.5%），高警觉症状阳性62名（36.9%）。多因素Logistic回归分析显示，对伤残持愤愤不平和对未来生活持听天由命态度是地震伤员急性应激障碍的独立影响因素（P＜0.05）。结论芦山地震伤员存在一定的急性应激反应，影响因素以再体验症状较突出，重点关注对伤残持愤愤不平和对未来生活持听天由命态度的地震伤员，给予医疗救援与治疗同时需积极、早期、及时针对伤员给予心理干预，降低地震伤员急性应激障碍发生率。%Objective To screen the prevalence of acute stress reaction of the wounded in Lushan earthquake and to guide the psychological aid after catastrophic events. Methods Totally 168 victims in Lushan Earthquake were surveyed by a self-designed general information questionnaire, and post-traumatic stress disorder symptoms civilian version (PTSD Checklist-Civilian Version, PCL-C). Results The total score of PCL-C of the 168 wounded was 29.51±10.85. Thirty-eight subjects (22.6%) were screened positive for acute stress reaction and 130 (77.4%) negative. The rate of re-experience was 75 (44.6%), that of avoiding numbness 16 (9.5%), and that of high-alert 62 (36.9%). Multivariable logistic regression analysis showed that anger due to disability and hopeless life in the future were the independent influence factors (P<0.05). Conclusion There is a certain incidence of acute stress reaction among the victims after Lushan earthquake and re-experience symptom is a significant influence factor. More attention should be paid to the wounded who are angry due to disability and those without hope for future life. In order to decrease the rate of acute stress reaction, more attention should be paid to not only victims ’ physical trauma, but also their psychological problems at early time as soon as possible.
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