转化医学杂志2026，Vol.15Issue(4)：541-546,6.DOI:10.3639/j.issn.2095-3097.2026.04.001
感染性休克机械通气患者撤机后并发创伤后应激障碍的影响因素分析
Analysis of Factors Influencing Post-Traumatic Stress Disorder After Weaning from Mechanical Ventilation in Patients with Septic Shock
摘要
Abstract
Objective To analyze the influencing factors of post-traumatic stress disorder(PTSD)in patients with septic shock after weaning from mechanical ventilation and to construct a nomogram model.Methods A total of 196 patients with septic shock who underwent mechanical ventilation admitted to the First Affiliated Hospital of Nanjing Medical University from January 2022 to August 2025 were selected.According to whether PTSD occurred after weaning from mechanical ventilation,the patients were divided into the PTSD-positive group(n=47)and the PTSD-negative group(n=149).The influencing factors of PTSD in patients with septic shock after weaning from mechanical ventilation were investigated by multivariate stepwise logistic regression analysis.A nomogram was drawn and the predictive value of the nomogram model for PTSD in patients with septic shock after weaning from mechanical ventilation was evaluated by the receiver operating characteristic curve.Results The proportions of females,negative coping style,introverted personality trait,low level of social support,mechanical ventilation duration>7 days,delirium duration>48 hours,and types of invasive procedures>3 in the PTSD-positive group were higher than those in the PTSD-negative group,and the acute physiology and chronic health evaluationⅡscore,critical-care pain observation tool(CPOT)score,and self-rating anxiety scale score were all higher in the PTSD-positive group than in the PTSD-negative group(P<0.05).Multivariate analysis showed that female(OR=3.579,95%CI:1.631-7.854),mechanical ventilation duration>7 days(OR=3.425,95%CI:1.752-6.695),delirium duration>48 hours(OR=3.347,95%CI:1.646-6.804),higher CPOT score(OR=2.606,95%CI:1.409-4.823),and negative coping style(OR=2.787,95%CI:1.443-5.385)were independent risk factors for PTSD in patients with septic shock after weaning from mechanical ventilation(P<0.05).The nomogram model showed that the concordance index was 0.875(95%CI:0.825-0.924).The area under the curve of the nomogram model for predicting PTSD in patients with septic shock after weaning from mechanical ventilation was 0.858(95%CI:0.808-0.905),with a specificity of 65.10%and a sensitivity of 91.49%.Conclusion Gender,mechanical ventilation duration,delirium duration,CPOT score,and coping style are independent risk factors for PTSD in patients with septic shock after weaning from mechanical ventilation.The nomogram model constructed based on these factors has good predictive performance.关键词
感染性休克/机械通气/创伤后应激障碍/影响因素Key words
septic shock/mechanical ventilation/post-traumatic stress disorder/influencing factors引用本文复制引用
董琦,张茹,丁玲玉,宋洪涛,秦天娥..感染性休克机械通气患者撤机后并发创伤后应激障碍的影响因素分析[J].转化医学杂志,2026,15(4):541-546,6.基金项目
国家自然科学基金项目(72404140) （72404140）
