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Article(id=1322927058908742167, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.17.012, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757779200000, receivedDateStr=2025-09-14, revisedDate=1783958400000, revisedDateStr=2026-07-14, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339989640, onlineDateStr=2026-10-30, pubDate=1788969600000, pubDateStr=2026-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339989640, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339989640, creator=13701087609, updateTime=1793339989640, updator=13701087609, issue=Issue{id=1322924415817757501, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='17', pageStart='2961', pageEnd='3152', issueExtLink='null', onlineDate='null', pubDate='1788969600000', pubDateStr='2026-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339359478, creator='13701087609', updateTime=1793343089343, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940060072542250, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940060072542251, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3043, endPage=3048, ext={EN=ArticleExt(id=1322927059395281432, articleId=1322927058908742167, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Latent profile analysis and influencing factors of post-traumatic stress disorder in women undergoing involuntary pregnancy loss, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the latent profiles of post-traumatic stress disorder(PTSD) in women undergoing involuntary termination of pregnancy,to analyze the characteristics of women in different profiles,and to investigate the related influencing factors.

Methods

From January to April 2025,205 women who underwent involuntary pregnancy loss and hospitalized in the tertiary grade A hospital in Changsha were selected as survey subjects.The General Information Questionnaire,the PTSD Symptom Scale-Self Report,and the Perceived Partner Responsiveness Scale were used for data collection.Latent profile analysis was conducted on PTSD symptoms.The univariate analysis and logistic regression analysis were employed to identify the influencing factors of these latent profiles.

Results

PTSD in women undergoing involuntary pregnancy loss was classified into three profiles:low symptom-adaptive type(57.6%),moderate symptom type(31.2%),and high symptom-cognitive-emotional dysregulation type(11.2%).Logistic regression analysis showed that education level,average monthly family income,occupation,history of involuntary pregnancy loss,conception method,regularity of prenatal check-ups,and perceived partner responsiveness were influencing factors for the latent profiles of PTSD in these women(all P<0.05).

Conclusions

Heterogeneity exists in the PTSD symptoms among women undergoing involuntary pregnancy loss.Healthcare professionals should implement targeted nursing interventions based on the characteristics of patients in different profiles to improve their mental health.

, authors=Jie LIU, Tingting XIANG, Yan XIONG, Shuting ZHOU, authorsList=Jie LIU, Tingting XIANG, Yan XIONG, Shuting ZHOU, authorCompany=null, correspAuthors=Yan XIONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927062582952475, articleId=1322927058908742167, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=非自愿终止妊娠女性创伤后应激障碍的潜在剖面分析及影响因素, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

探讨非自愿终止妊娠女性创伤后应激障碍的潜在剖面，分析不同剖面女性特征并探讨影响因素。

方法

2025年1月—4月选取在长沙市某三级甲等医院住院治疗的205例非自愿终止妊娠女性为调查对象，使用一般资料调查表、创伤后应激障碍症状筛查量表修订版、感知伴侣回应性量表进行问卷调查，对创伤后应激障碍进行潜在剖面分析，采用单因素分析、Logistic回归分析识别其潜在剖面的影响因素。

结果

非自愿终止妊娠女性创伤后应激障碍分为低症状-适应型（57.6%）、中症状型（31.2%）、高症状-认知情绪失调型（11.2%）3个剖面。Logistic回归分析显示，文化程度、家庭月收入、职业、有无非自愿终止妊娠经历、受孕方式、是否按时产检、感知伴侣回应性是非自愿终止妊娠女性创伤后应激障碍潜在剖面的影响因素（均P<0.05）。

结论

非自愿终止妊娠女性创伤后应激障碍存在群体异质性，医护人员需根据不同剖面病人的特征采取针对性护理干预措施，改善其心理健康。

, authors=刘婕, 向婷婷, 熊艳*, *, 周书婷, authorsList=刘婕, 向婷婷, 熊艳, 周书婷, authorCompany=null, correspAuthors=熊艳, authorNote=

刘婕，护师，硕士研究生

, correspAuthorsNote=
熊艳，E-mail：
XIONG Yan, E-mail:
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刘婕，护师，硕士研究生

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tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, companyId=1322927063132406300, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Hunan Provincial Maternal and Child Health Care Hospital/NHC Key Laboratory of Birth Defect Research and Prevention, Hunan 410028 China), AuthorCompanyExt(id=1322927063153377822, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, companyId=1322927063132406300, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1湖南省妇幼保健院 国家卫生健康委员会出生缺陷研究与预防重点实验室，湖南 410028)])], figs=[ArticleFig(id=1322927067737752125, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=EN, label=Figure 1, caption=Characteristic distribution of latent profiles of post-traumatic stress disorder in women undergoing involuntary pregnancy loss, figureFileSmall=XzGigT7xFcdaHRzDRjsmjA==, figureFileBig=jFWdvU7Y0aF5ehCvmTk7xQ==, tableContent=null), ArticleFig(id=1322927067834221118, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=CN, label=图1, caption=非自愿终止妊娠女性PTSD潜在剖面的特征分布, figureFileSmall=XzGigT7xFcdaHRzDRjsmjA==, figureFileBig=jFWdvU7Y0aF5ehCvmTk7xQ==, tableContent=null), ArticleFig(id=1322927068022964799, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=EN, label=Table 1, caption=

Fit indices of different models

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AICBICaBICEntropyP类别概率
LMRTBLRT
111 790.15111 923.07211 796.338
29 652.4309 855.1349 661.8650.9950.002<0.0010.844/0.156
38 816.4109 088.8978 829.0930.9740.024<0.0010.312/0.576/0.112
48 497.5078 839.7788 513.4380.9790.067<0.0010.097/0.566/0.308/0.029
), ArticleFig(id=1322927068102656576, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=CN, label=表1, caption=

不同模型的拟合指标

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AICBICaBICEntropyP类别概率
LMRTBLRT
111 790.15111 923.07211 796.338
29 652.4309 855.1349 661.8650.9950.002<0.0010.844/0.156
38 816.4109 088.8978 829.0930.9740.024<0.0010.312/0.576/0.112
48 497.5078 839.7788 513.4380.9790.067<0.0010.097/0.566/0.308/0.029
), ArticleFig(id=1322927068190736961, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=EN, label=Table 2, caption=

Univariate analysis of influencing factors of latent profiles of PTSD in women undergoing involuntary pregnancy loss

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类低症状-适应型（n=118）中症状型（n=64）高症状-认知情绪失调型（n=23）统计值P
年龄（例）≤24岁5110.433①
>24~29岁341610
>29~34岁47326
>34岁32156
宗教信仰（例）无11359170.006①
有556
婚姻状况（例）未婚1277
已婚10251160.038①
离异460
现居住地（例）城市10452120.001①
农村141211
文化程度（例）初中及以下1060
高中/中专1611130.001①
专科及以上924710
职业（例）在职91468χ2=16.724<0.001
无业271815
家庭平均月收入（例）<4 000元12150
4 000~8 000元393223<0.001①
>8 000元67170
子女数（例）0个603716
1个432070.317①
≥2个1570
孕周（例）孕<14周10952160.005①
孕14~28周9127
受孕方式（例）促排卵860
体外受精-胚胎移植51000.018①
自然妊娠1054823
按时产检（例）是835823<0.001①
否3560
终止妊娠原因（例）异位妊娠591870.005①
稽留流产442911
胎儿畸形485
自然流产350
其他840
非自愿终止妊娠经历（例）有3728130.038①
无813610
感知伴侣回应性（分）71（60，79）62（52，73）49（46，65）H=21.366<0.001
), ArticleFig(id=1322927068278817346, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=CN, label=表2, caption=

非自愿终止妊娠女性PTSD潜在剖面影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类低症状-适应型（n=118）中症状型（n=64）高症状-认知情绪失调型（n=23）统计值P
年龄（例）≤24岁5110.433①
>24~29岁341610
>29~34岁47326
>34岁32156
宗教信仰（例）无11359170.006①
有556
婚姻状况（例）未婚1277
已婚10251160.038①
离异460
现居住地（例）城市10452120.001①
农村141211
文化程度（例）初中及以下1060
高中/中专1611130.001①
专科及以上924710
职业（例）在职91468χ2=16.724<0.001
无业271815
家庭平均月收入（例）<4 000元12150
4 000~8 000元393223<0.001①
>8 000元67170
子女数（例）0个603716
1个432070.317①
≥2个1570
孕周（例）孕<14周10952160.005①
孕14~28周9127
受孕方式（例）促排卵860
体外受精-胚胎移植51000.018①
自然妊娠1054823
按时产检（例）是835823<0.001①
否3560
终止妊娠原因（例）异位妊娠591870.005①
稽留流产442911
胎儿畸形485
自然流产350
其他840
非自愿终止妊娠经历（例）有3728130.038①
无813610
感知伴侣回应性（分）71（60，79）62（52，73）49（46，65）H=21.366<0.001
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Multivariate analysis of latent profiles of PTSD in women undergoing involuntary termination of pregnancy

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剖面变量回归系数标准误Wald χ2值POR值[95%CI]
中症状型常量1.0761.4820.5280.468
感知伴侣回应性-0.0310.0144.9860.0260.970[0.944,0.996]
家庭平均月收入（<4 000元)1.4920.5716.8160.0094.446[1.451,13.629]
受孕方式（体外受精-胚胎移植)1.5810.7404.5620.0334.857[1.139,20.715]
按时产检（否）-1.8510.6957.1030.0080.157[0.040,0.613]
高症状-认知情绪失调型常量-23.1439 184.950<0.0010.998
感知伴侣回应性-0.1660.0705.5490.0180.847[0.738,0.973]
文化程度（高中/中专）7.2042.9465.9780.0141 344.890[4.175,433 237.575]
职业（无业）4.9041.8287.1940.007134.878[3.746,4 856.827]
非自愿终止妊娠经历（有）4.5122.0594.8040.02891.088[1.611,5 149.157]
), ArticleFig(id=1322927068425617988, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322927058908742167, language=CN, label=表3, caption=

非自愿终止妊娠女性PTSD潜在剖面影响因素的多因素分析

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剖面变量回归系数标准误Wald χ2值POR值[95%CI]
中症状型常量1.0761.4820.5280.468
感知伴侣回应性-0.0310.0144.9860.0260.970[0.944,0.996]
家庭平均月收入（<4 000元)1.4920.5716.8160.0094.446[1.451,13.629]
受孕方式（体外受精-胚胎移植)1.5810.7404.5620.0334.857[1.139,20.715]
按时产检（否）-1.8510.6957.1030.0080.157[0.040,0.613]
高症状-认知情绪失调型常量-23.1439 184.950<0.0010.998
感知伴侣回应性-0.1660.0705.5490.0180.847[0.738,0.973]
文化程度（高中/中专）7.2042.9465.9780.0141 344.890[4.175,433 237.575]
职业（无业）4.9041.8287.1940.007134.878[3.746,4 856.827]
非自愿终止妊娠经历（有）4.5122.0594.8040.02891.088[1.611,5 149.157]
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非自愿终止妊娠女性创伤后应激障碍的潜在剖面分析及影响因素
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刘婕 , 向婷婷 , 熊艳 *, * , 周书婷
护理研究 | 科研论著 2026,40(17): 3043-3048
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护理研究 |科研论著 2026 , 40 (17) : 3043 -3048
非自愿终止妊娠女性创伤后应激障碍的潜在剖面分析及影响因素
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刘婕, 向婷婷, 熊艳*, * , 周书婷
作者信息
  • 1湖南省妇幼保健院 国家卫生健康委员会出生缺陷研究与预防重点实验室，湖南 410028
通讯作者:
熊艳，E-mail：
XIONG Yan, E-mail:
作者简介:

刘婕，护师，硕士研究生

Latent profile analysis and influencing factors of post-traumatic stress disorder in women undergoing involuntary pregnancy loss
Jie LIU, Tingting XIANG, Yan XIONG , Shuting ZHOU
Affiliations
  • 1Hunan Provincial Maternal and Child Health Care Hospital/NHC Key Laboratory of Birth Defect Research and Prevention, Hunan 410028 China
出版时间: 2026-09-10 doi: 10.12102/j.issn.1009-6493.2026.17.012
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摘要
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目的

探讨非自愿终止妊娠女性创伤后应激障碍的潜在剖面，分析不同剖面女性特征并探讨影响因素。

方法

2025年1月—4月选取在长沙市某三级甲等医院住院治疗的205例非自愿终止妊娠女性为调查对象，使用一般资料调查表、创伤后应激障碍症状筛查量表修订版、感知伴侣回应性量表进行问卷调查，对创伤后应激障碍进行潜在剖面分析，采用单因素分析、Logistic回归分析识别其潜在剖面的影响因素。

结果

非自愿终止妊娠女性创伤后应激障碍分为低症状-适应型（57.6%）、中症状型（31.2%）、高症状-认知情绪失调型（11.2%）3个剖面。Logistic回归分析显示，文化程度、家庭月收入、职业、有无非自愿终止妊娠经历、受孕方式、是否按时产检、感知伴侣回应性是非自愿终止妊娠女性创伤后应激障碍潜在剖面的影响因素（均P<0.05）。

结论

非自愿终止妊娠女性创伤后应激障碍存在群体异质性，医护人员需根据不同剖面病人的特征采取针对性护理干预措施，改善其心理健康。

妊娠  /  非自愿终止妊娠  /  创伤后应激障碍  /  潜在剖面分析  /  影响因素
Objective

To explore the latent profiles of post-traumatic stress disorder(PTSD) in women undergoing involuntary termination of pregnancy,to analyze the characteristics of women in different profiles,and to investigate the related influencing factors.

Methods

From January to April 2025,205 women who underwent involuntary pregnancy loss and hospitalized in the tertiary grade A hospital in Changsha were selected as survey subjects.The General Information Questionnaire,the PTSD Symptom Scale-Self Report,and the Perceived Partner Responsiveness Scale were used for data collection.Latent profile analysis was conducted on PTSD symptoms.The univariate analysis and logistic regression analysis were employed to identify the influencing factors of these latent profiles.

Results

PTSD in women undergoing involuntary pregnancy loss was classified into three profiles:low symptom-adaptive type(57.6%),moderate symptom type(31.2%),and high symptom-cognitive-emotional dysregulation type(11.2%).Logistic regression analysis showed that education level,average monthly family income,occupation,history of involuntary pregnancy loss,conception method,regularity of prenatal check-ups,and perceived partner responsiveness were influencing factors for the latent profiles of PTSD in these women(all P<0.05).

Conclusions

Heterogeneity exists in the PTSD symptoms among women undergoing involuntary pregnancy loss.Healthcare professionals should implement targeted nursing interventions based on the characteristics of patients in different profiles to improve their mental health.

pregnancy  /  involuntary pregnancy loss  /  post-traumatic stress disorder  /  latent profile analysis  /  influencing factors
刘婕, 向婷婷, 熊艳, 周书婷. 非自愿终止妊娠女性创伤后应激障碍的潜在剖面分析及影响因素. 护理研究, 2026 , 40 (17) : 3043 -3048 . DOI: 10.12102/j.issn.1009-6493.2026.17.012
Jie LIU, Tingting XIANG, Yan XIONG, Shuting ZHOU. Latent profile analysis and influencing factors of post-traumatic stress disorder in women undergoing involuntary pregnancy loss[J]. Chinese Nursing Research, 2026 , 40 (17) : 3043 -3048 . DOI: 10.12102/j.issn.1009-6493.2026.17.012
正文
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非自愿终止妊娠（involuntary pregnancy loss,IPL）是指因自然流产、异位妊娠、胎儿畸形或其他因素（意外情况或母体因素）胎儿无法存活而终止妊娠的事件[1]。据统计，全球每年约发生550万例非自愿终止妊娠事件，其中超过39%的女性经历非自愿终止妊娠后出现创伤后应激障碍（post-traumatic stress disorder,PTSD）[2]。PTSD是指个体经历或间接经历创伤事件后产生的一种严重的精神焦虑障碍，核心症状包括创伤再体验、回避症状、负性认知和情绪改变以及警觉性和反应性增强[3]。非自愿终止妊娠女性被诊断为PTSD的可能性较经历其他应激事件病人约高出7倍，且症状可能持续到下次妊娠，甚至延续多年[4]。《中国妇女发展纲要（2021—2030年）》提示，育龄女性的心理健康应受到重视，对经历非自愿终止妊娠的女性应进行关爱[5]。目前，关于非自愿终止妊娠女性PTSD的研究多停留在以变量为中心的研究方法，忽略了个体异质性差异[6-7]。本研究基于潜在剖面分析（latent profile analysis，LPA）识别非自愿终止妊娠女性PTSD的不同亚组，并探讨其影响因素，为临床开展更有针对性和预见性的心理干预提供依据。
1　对象与方法
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1.1　调查对象
采用便利抽样法，选取2025年1月—4月在长沙市某三级甲等医院住院治疗的非自愿终止妊娠女性作为调查对象。纳入标准：年龄≥18岁；因自然流产、异位妊娠、胎儿畸形和其他原因（意外情况或母体因素）胎儿无法存活而需终止妊娠；知情并自愿参与本研究。排除标准：认知障碍、听力障碍者；正在参加其他研究。根据回归分析中样本量至少为自变量数10~15倍原则[8]，本研究纳入14个自变量，考虑10%的失访率，所需样本量为154~231例。本研究已经湖南省妇幼保健院伦理委员会批准（编号：AF-2025-020）。
1.2　调查工具
1.2.1　一般资料调查表
由研究者自行设计，包括年龄、宗教信仰、婚姻状况、文化程度、居住地、职业情况、家庭平均月收入、子女数量、孕周、本次受孕方式、是否按时产检、本次终止妊娠原因、有无非自愿终止妊娠经历。
1.2.2　PTSD症状筛查量表修订版（Post-traumatic Stress Disorder Checklist for DSM-5，PCL-5）
PCL-5由Blevins等[9]依据《精神障碍诊断与统计手册（第5版）》中关于PTSD的诊断标准修订，可用于PTSD治疗前后的评估，为PTSD病人的筛查提供参考性诊断。该量表共有闯入（条目1~5）、回避（条目6、条目7）、负性认知和情绪改变（条目8~14）及高唤醒（条目15~20）4个维度、20个条目。采取Likert 5级评分法，0分为完全没有，4分为非常严重，总分80分，得分越高，表示PTSD越严重，其中总分>33分表示具有较明显的PTSD。研究表明，修订版PCL-5具有良好的信效度[10-11]，本研究中该量表的Cronbach's α系数为0.968。
1.2.3　感知伴侣回应性量表（Perceived Partner Responsiveness Scale,PPRS）
PPRs由Reis等[12]编制，经杨舒程[13]于2019年汉化为中文版，用以测评亲密关系中个体主观感知到伴侣关注自己核心特征并予以积极性回应的程度。该量表为单维度量表，共12个条目，采用Likert 7级计分法，从“完全不符合”到“完全符合”依次计1~7分，总分12~84分，得分越高，表明个体感知到的伴侣回应越多。本研究中该量表的Cronbach's α系数为0.983。
1.3　资料收集
问卷由经培训的2名调查员发放，于病人入院24 h内进行资料收集。调查前向病人解释调查目的、意义和填写要求，征得知情同意后再发放问卷。问卷当场回收并核查，及时补缺。
1.4　统计学方法
运用Mplus 8.7进行潜在剖面分析，模型适配指标包括：1）艾凯克信息准则（Akaike information criterion,AIC）、贝叶斯信息准则（Bayesian information criterion,BIC）、样本校正后信息准则（aBIC），统计值越小表示拟合度越好；2）信息熵（Entropy）取值0~1，越接近1表示分类越精确，当熵值>0.8时提示分类精确率>90%；3）采用罗-梦戴尔-鲁本校正似然比检验（Lo-Mendel-Rubin likelihood ratio test,LMRT）和基于Bootstrap似然比检验（Bootstrap likelihood ratio test,BLRT）比较模型。P<0.05时表示k个模型拟合优于k-1个模型。采用SPSS26.0软件进行χ2检验、Fisher确切概率法、Kruskal-Wallis秩和检验、无序多分类Logistic回归分析。检验水准α=0.05。
2　结果
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2.1　非自愿终止妊娠女性PTSD得分及发生情况
本研究最终获得有效样本量205例，其中有PTSD阳性症状病人32例（15.61%）。非自愿终止妊娠女性PCL-5总分为15.00（7.00，25.50）分，闯入维度、回避维度、负性认知和情绪改变维度及高唤醒维度得分分别为5.00（3.00，8.00）分、2.00（0.00，3.00）分、3.00（1.00，8.00）分、4.00（2.00，8.00）分。
2.2　非自愿终止妊娠女性PTSD的潜在剖面分析
以PCL-5的20个条目得分进行潜在剖面分析，AIC、BIC、aBIC随着类别数的增加而减小，但到4类别时P（LMRT）>0.05，说明模型4不优于模型3，综合比较各模型拟合指标后，以模型3作为最佳拟合模型，见表1。基于模型3，各剖面在PCL-5的20个条目得分均值见图1。非自愿终止妊娠女性PTSD的3个剖面在各条目上均无交点，不同剖面的形态趋势较为一致。剖面1：病人118例（57.6%），PCL-5中闯入、回避、负性认知、高唤醒所有维度得分均最低，命名为“低症状-适应型”；剖面2：病人64例（31.2%），各维度得分在3个类别中属于中等水平，命名为“中症状型”；剖面3：病人23例（11.2%），各维度得分均属于高水平，其中负性认知和情绪改变维度得分相对更高，命名为“高症状-认知情绪失调型”。
2.3　非自愿终止妊娠女性PTSD潜在剖面影响因素的单因素分析
不同潜在剖面在有无宗教信仰、婚姻状况、现居住地、文化程度、职业、家庭平均月收入、孕周、受孕方式、是否按时产检、终止妊娠原因、有无非自愿终止妊娠经历、感知伴侣回应性方面比较，差异均有统计学意义（均P<0.05），见表2。
2.4　非自愿终止妊娠女性PTSD潜在剖面影响因素的多因素分析
将非自愿终止妊娠女性PTSD的3个潜在剖面作为因变量（以低症状-适应型作为参照），将单因素分析中有统计学意义的变量纳入回归模型。结果见表3。
3　讨论
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3.1　非自愿终止妊娠女性PTSD存在群体异质性
本研究显示，非自愿终止妊娠女性PTSD的发生率为15.61%，低于Horesh等[14]的研究结果，可能与研究对象孕周分布不同有关，Horesh等[14]的研究对象平均孕周为27.92周，而本研究对象86.3%为早期妊娠（≤13周）。孕周是非自愿终止妊娠病人发生PTSD的独立影响因素，且孕周越大终止妊娠女性PTSD得分越高[15]。本研究基于潜在剖面分析识别出经历非自愿终止妊娠的女性PTSD具有3个潜在剖面，存在明显群体异质性。1）低症状-适应型占比最大（57.6%），表明该类型女性经历非自愿终止妊娠后能调动积极认知并有效利用社会支持资源缓冲创伤，实现良好心理适应。尽管该类型女性的症状得分总体处于较低水平，但闯入症状相对突出，主要表现为主动回忆触发的哀伤感，因此，医护人员应注重为该类女性提供哀伤辅导，促进心理康复和情感恢复[16]，同时可组织同伴支持活动，引导该群体分享经验，增强积极心态改变的动机和信心[17]。2）中症状型占31.2%，是从适应良好状态发展为阳性症状的过渡群体。医护人员需持续关注此类女性的心理动态变化，可采用表达性书写等积极心理干预措施，引导其正确认识妊娠结局，预防其发展为高症状组[18]。3）高症状-认知情绪失调型占11.2%，该类型核心特征为负性认知与情绪功能失调，表现为深陷于过度自责和内疚，同时伴有强烈的负性情绪体验及难以感受积极情感，不仅使女性身心健康全面受损，更深刻冲击其家庭关系，并对未来生育决策构成巨大心理障碍，医护人员亟须在临床实践中及早识别此类个体，为其提供强化、多靶点、循证的创伤治疗（如认知行为疗法、眼动脱敏与再加工、情绪调节训练等）[7]，以打破维持症状的恶性循环，修复断裂的社会纽带，增强个体在创伤后的心理韧性与整体适应能力。
3.2　非自愿终止妊娠女性PTSD潜在剖面的影响因素
3.2.1　人口学因素
本研究显示，文化程度、家庭平均月收入和职业是非自愿终止妊娠女性PTSD不同潜在剖面的影响因素。
文化程度为高中/中专的女性更易归于高症状-认知情绪失调型，可能由于文化程度越低的女性对非自愿终止妊娠事件的认知程度越低，更易产生恐惧心理，陷入负性认知情绪失调循环；同时，由于文化程度低的女性获取知识的能力有限，可能促发非理性归因（如将非自愿终止妊娠视为羞耻、道德惩罚），加剧创伤体验内化。因此，医务人员应引导该类女性对非自愿终止妊娠事件进行正确归因，并通过社区及社交媒体加强宣传围生期保健知识，拓宽知识获取的途径，为非自愿终止妊娠女性提供良好的社会支持环境。
家庭平均月收入<4 000元的女性更易归于中症状型，与既往研究结果[19-20]类似，可能是由于低收入病人需承担非自愿终止妊娠治疗的经济负担，同时经济约束导致放大未来不确定性（如担忧无力承担下次妊娠医疗支出），从而加剧心理压力，导致PTSD风险攀升。医护人员可积极向病人及家属提供财务援助信息，帮助病人选择经济毒性较轻、依从性高的治疗方案，以减轻病人医疗经济压力，促进其更好地恢复身体及心理健康。
无业的女性更易归于高症状-认知情绪失调型，与Baransel等[21]研究结果类似。分析原因可能是：对于无业状态的女性，家庭和孩子是生活的核心，职业环境缺失使社交网络萎缩，非自愿终止妊娠事件发生后心理压力大，而沟通和宣泄渠道减少；另外，空闲时间增加可能导致创伤记忆再激活，从而加重PTSD症状。医护人员可鼓励病人增加社交活动、培养兴趣爱好等转移自己对非自愿终止妊娠事件的过度关注。
3.2.2　生育因素
本研究显示，有无非自愿终止妊娠经历、受孕方式以及是否按时产检是非自愿终止妊娠女性PTSD不同潜在剖面的影响因素。
非自愿终止妊娠经历的女性更易归于高症状-认知情绪失调型，与Farren等[22]的研究结果不同。可能与本研究调查时聚焦于得知胎儿异常的诊断到终止妊娠期间，初发者因缺乏心理预期与应对经验，易被突发创伤事件击溃，表现为高症状型。医护人员应对初次非自愿终止妊娠经历的女性实施“零时差干预”，调动病人的积极心理，将初发者的经验劣势转化为可塑性优势。
体外受精-胚胎移植的女性更易归于中症状型，与傅利芹等[23]的研究结果相符。可能由于通过辅助生殖技术成功受孕的女性生育压力较大，对妊娠的期望值较高，在面对不良妊娠结局时更易造成情绪波动，进而出现抑郁、焦虑等，导致发生PTSD的风险升高。医护人员应该重点关注该类女性的心理状态，可为其提供信息支持、支持性心理治疗等方法帮助其建立积极应对方式[24]，缓解负性情绪，避免形成恶性循环。
未按时产检的女性更易归于低症状-适应型，可能由于本研究人群以异位妊娠为主（41.0%），其突发性导致多数病人未到常规产检时间即面临终止妊娠（早期妊娠占86.3%），丧失对象仍停留在概念化胚胎阶段，削弱了现实感创伤。
3.2.3　感知伴侣回应性
本研究结果显示，非自愿终止妊娠女性感知伴侣回应性对其PTSD潜在剖面产生负向影响（P<0.05）。分析原因可能是：伴侣作为最亲密的照顾者，能够提供关键的陪伴与情感支持，高水平的伴侣回应有助于双方共同应对孕期丧失带来的身心创伤，有效减少女性的创伤性反刍与自责倾向，从而缓解其精神压力。有研究证明伴侣感知伴侣回应性可影响病人的生育忧虑[25]。Sun等[26]为胎儿异常引产孕产妇开展家庭支持干预，结果发现孕产妇PTSD水平得到显著改善。因此，在今后的临床工作中，医护人员应鼓励并引导伴侣积极回应孕期丧失女性的情感需求，帮助其以更积极的态度面对创伤事件，减轻恐惧感和内疚自责行为，进而增强她们再次生育的信心与勇气。
4　小结
收起
非自愿终止妊娠女性PTSD存在低症状-适应型、中症状型、高症状-认知情绪失调型3个潜在剖面，且受文化程度、家庭平均月收入、职业、有无非自愿终止妊娠经历、受孕方式、是否按时产检、感知伴侣回应性的影响。但本研究仅调查1所医院非自愿终止妊娠女性PTSD情况，样本量偏小且为单中心调查，未来应进一步扩大样本量、采取多中心纵向研究、纳入更多观测变量，弥补本研究结果的不足。

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2026年第40卷第17期
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doi: 10.12102/j.issn.1009-6493.2026.17.012
  • 接收时间：2025-09-14
  • 首发时间：2026-10-30
  • 出版时间：2026-09-10
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  • 收稿日期：2025-09-14
  • 修回日期：2026-07-14
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    1湖南省妇幼保健院 国家卫生健康委员会出生缺陷研究与预防重点实验室，湖南 410028

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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