外伤性硬脑膜下积液者90项症状自评量表评分分析

目的探讨外伤性硬脑膜下积液者的90项症状自评量表(Symptom Check List-90,SCL-90)分值变化的影响因素。方法选取皖南医学院司法鉴定中心2007—2018年受理的142例外伤性硬脑膜下积液的被鉴定人进行SCL-90测试,分析测得SCL-90得分与全国常模的差异,以及性别、年龄、文化程度、积液范围及部位对SCL-90分值的影响。结果外伤性硬脑膜下积液SCL-90的躯体化、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子分值及总均分与全国常模比较,差异有统计学意义(P<0.05),男女性之间抑郁和敌对因子分值差异有统计学意义(P<0.05),不同年龄段间强迫、焦虑、恐怖因子分值及总均分差异有统计学意义(P<0.05),不同受教育程度人群中敌对、偏执和精神病性因子分值差异有统计学意义(P<0.05),单部位、双部位与多部位间抑郁、焦虑、敌对、恐怖因子分值及总均分差异有统计学意义(P<0.05),左脑区、双脑区与右脑区相比躯体化、抑郁、焦虑因子分值及总均分差异有统计学意义(P<0.05)。结论外伤性硬脑膜下积液可引起一定的精神心理变化,该变化与蛛网膜破裂的原发伤以及硬脑膜下积液范围和部位相关,进行精神心理症状评估时应注意上述因素的影响。

Analysis of Scores of SCL-90 of Patients with Traumatic Subdural Effusion

Objective To investigate the factors affecting changes of Symptom Check List-90(SCL-90)of patients with traumatic subdural effusion.Methods One hundred and forty-two cases of patients with traumatic subdural effusion from the Center of Forensic Identification,Wannan Medical College collected from 2007—2018 were tested with SCL-90.The differences between SCL-90 results and the national norm and the influences of gender,age,education level,the number of effusion sites and location on SCL-90 results were analyzed.Results The differences between the scores of somatization,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia and psychosis factors and total mean scores in SCL-90 of traumatic subdural effusion and that of the national norm had statistical significance(P<0.05).The differences in depression and hostility factor scores between males and females had statistical significance(P<0.05).The differences in compulsion,anxiety and terror factor scores and total mean scores among different age groups had statistical significance(P<0.05).The differences in hostility,paranoia and psychosis factors among patients with different degrees of education had statistical significance(P<0.05).The differences in depression,anxiety,hostility and terror factor scores and total mean scores among single-site group,double-site group and multi-site group had statistical significance(P<0.05).The differences in somatization,depression and anxiety factor scores and total mean scores between the right cerebral hemisphere group and the left cerebral hemisphere group and bilateral hemisphere group had statistical significance(P<0.05).Conclusion Traumatic subdural effusion can cause certain psychological changes,which are related to the primary trauma of arachnoid tear as well as the number and location of effusion sites.Attention should be paid to the influence of the above factors during the assessment of psychological symptoms.