中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2010年
12期
713-718
,共6页
刘文军%路晓光%阎丽君%冯博%岳玉和
劉文軍%路曉光%閻麗君%馮博%嶽玉和
류문군%로효광%염려군%풍박%악옥화
维持性血液透析%生活质量%临床研究
維持性血液透析%生活質量%臨床研究
유지성혈액투석%생활질량%림상연구
Maintaining hemodialysis%Life quality%Clinical research
目的 研究维持性血液透析(MHD)患者的生活质量及其影响因素. 方法 选择本院血液透析中心102例MHD患者,采用问卷调查方式,利用慢性肾脏病专用量表KDQOL-SFTM1.3评价患者肾脏病与透析相关生存质量(KDTA)和一般健康相关生存质量(SF-36),并分析其影响因素. 结果 量表各影响因素中,医护人员的鼓励、社会支持、症状、认知功能、社会关系质量和患者满意程度评分较高,而性功能、肾脏病给生活带来的负担、总体健康期望和自我健康评价评分则较低.影响因素方面,女性患者躯体功能、躯体疼痛评分(分)明显低于男性(63.52±17.96比71.65±18.66,64.33±21.23比76.58±19.20,均P<0.05).年龄>60岁患者工作状况、性功能评分(分)较≤40岁和40～60岁患者显著升高(61.98±13.63比52.27±7.54和55.23±19.97,68.33±4.04比5.45±9.34和15.81±26.92,均P<0.05);且60岁以上者患者满意程度评分较高,躯体功能评分较低.原发病中仅糖尿病患者受到医护人员鼓励最多[(93.57±11.29)分].白蛋白<3.5 g/L患者KDTA总评分、肾脏病对日常生活的影响、认知功能、躯体功能、总体健康期望及与以往比较评分(分)均明显低于白蛋白≥3.5 g/L者(53.62±8.87比61.26±9.42,44.58±12.52比57.47±17.15,65.56±20.60比78.18±15.73,54.38±19.73比68.87±17.57,31.11±10.23比41.19±66.27,44.44±27.06比68.57±26.94,均P<0.05).透析≥6年患者症状、躯体疼痛、精力状况、总体健康期望评分(分)较高(分别为86.92±6.67、85.08±57.34、 78.40±13.04、 53.33±24.22),而社会支持评分(分)以透析3～6年者最高(94.23±10.96,均P<0.05).而不同血红蛋白和尿素清除指数水平对MHD患者生活质量无明显影响. 结论 MHD患者对自己的信心不足,个人负担较重;营养状态对患者的生活质量影响较大.因此MHD患者的生活质量仍需加强,尤其营养状态方面更是今后的重点.
目的 研究維持性血液透析(MHD)患者的生活質量及其影響因素. 方法 選擇本院血液透析中心102例MHD患者,採用問捲調查方式,利用慢性腎髒病專用量錶KDQOL-SFTM1.3評價患者腎髒病與透析相關生存質量(KDTA)和一般健康相關生存質量(SF-36),併分析其影響因素. 結果 量錶各影響因素中,醫護人員的鼓勵、社會支持、癥狀、認知功能、社會關繫質量和患者滿意程度評分較高,而性功能、腎髒病給生活帶來的負擔、總體健康期望和自我健康評價評分則較低.影響因素方麵,女性患者軀體功能、軀體疼痛評分(分)明顯低于男性(63.52±17.96比71.65±18.66,64.33±21.23比76.58±19.20,均P<0.05).年齡>60歲患者工作狀況、性功能評分(分)較≤40歲和40～60歲患者顯著升高(61.98±13.63比52.27±7.54和55.23±19.97,68.33±4.04比5.45±9.34和15.81±26.92,均P<0.05);且60歲以上者患者滿意程度評分較高,軀體功能評分較低.原髮病中僅糖尿病患者受到醫護人員鼓勵最多[(93.57±11.29)分].白蛋白<3.5 g/L患者KDTA總評分、腎髒病對日常生活的影響、認知功能、軀體功能、總體健康期望及與以往比較評分(分)均明顯低于白蛋白≥3.5 g/L者(53.62±8.87比61.26±9.42,44.58±12.52比57.47±17.15,65.56±20.60比78.18±15.73,54.38±19.73比68.87±17.57,31.11±10.23比41.19±66.27,44.44±27.06比68.57±26.94,均P<0.05).透析≥6年患者癥狀、軀體疼痛、精力狀況、總體健康期望評分(分)較高(分彆為86.92±6.67、85.08±57.34、 78.40±13.04、 53.33±24.22),而社會支持評分(分)以透析3～6年者最高(94.23±10.96,均P<0.05).而不同血紅蛋白和尿素清除指數水平對MHD患者生活質量無明顯影響. 結論 MHD患者對自己的信心不足,箇人負擔較重;營養狀態對患者的生活質量影響較大.因此MHD患者的生活質量仍需加彊,尤其營養狀態方麵更是今後的重點.
목적 연구유지성혈액투석(MHD)환자적생활질량급기영향인소. 방법 선택본원혈액투석중심102례MHD환자,채용문권조사방식,이용만성신장병전용량표KDQOL-SFTM1.3평개환자신장병여투석상관생존질량(KDTA)화일반건강상관생존질량(SF-36),병분석기영향인소. 결과 량표각영향인소중,의호인원적고려、사회지지、증상、인지공능、사회관계질량화환자만의정도평분교고,이성공능、신장병급생활대래적부담、총체건강기망화자아건강평개평분칙교저.영향인소방면,녀성환자구체공능、구체동통평분(분)명현저우남성(63.52±17.96비71.65±18.66,64.33±21.23비76.58±19.20,균P<0.05).년령>60세환자공작상황、성공능평분(분)교≤40세화40～60세환자현저승고(61.98±13.63비52.27±7.54화55.23±19.97,68.33±4.04비5.45±9.34화15.81±26.92,균P<0.05);차60세이상자환자만의정도평분교고,구체공능평분교저.원발병중부당뇨병환자수도의호인원고려최다[(93.57±11.29)분].백단백<3.5 g/L환자KDTA총평분、신장병대일상생활적영향、인지공능、구체공능、총체건강기망급여이왕비교평분(분)균명현저우백단백≥3.5 g/L자(53.62±8.87비61.26±9.42,44.58±12.52비57.47±17.15,65.56±20.60비78.18±15.73,54.38±19.73비68.87±17.57,31.11±10.23비41.19±66.27,44.44±27.06비68.57±26.94,균P<0.05).투석≥6년환자증상、구체동통、정력상황、총체건강기망평분(분)교고(분별위86.92±6.67、85.08±57.34、 78.40±13.04、 53.33±24.22),이사회지지평분(분)이투석3～6년자최고(94.23±10.96,균P<0.05).이불동혈홍단백화뇨소청제지수수평대MHD환자생활질량무명현영향. 결론 MHD환자대자기적신심불족,개인부담교중;영양상태대환자적생활질량영향교대.인차MHD환자적생활질량잉수가강,우기영양상태방면경시금후적중점.
Objective To determine the influencing factors and life quality of patients undergoing maintaining hemodialysis(MHD). Methods One hundred and two MHD patients in hemodialysis center were enrolled,and a questionnaire investigation using KDQOL-SFTM 1.3 was employed.This questionnaire was disease-specific for chronic kidney disease.The object was to evaluate the quality of life,in relation with the patients' kidney disease and dialysis(KDTA) and the patients' general health(SF-36),and to analyze the influencing factors. Results Among the influencing factors revealed in questionnaire investigation,the items such as encouragement from medical staff,social support,symptoms,cognitive function,quality of social relationship and satisfaction degree of patients won higher scores,while the items such as sex function,difficulties in daily activity due to kidney disease,expectation of general health and self-evaluation of health won lower scores.Among the influencing factors,the scores of physical functions and body pain were much lower in female than male patients(63.52±17.96 vs.71.65±18.66,64.33±21.23 vs.76.58±19.20,both P<0.05).Patients of age>60 won higher scores than patients of age≤40 and 4060 in respect to work condition and sex function(61.98±13.63 vs.52.27±7.54 and 55.23±19.97,68.33±4.04 vs.5.45±9.34 and 15.81±26.92,all P<0.05);patients of 60 years old or older won higher scores in respect of satisfaction degree of patients but lower scores in respect of physical functions.Among primary diseases,only patients with diabetes won much encouragement from medical staff(93.57±11.29).Patients whose serum albumin was lower than 3.5 g/L won much lower scores than those with serum albumin higher than 3.5 g/L in respect of scoring of KDTA,influence to daily life due to kidney disease,cognitive function,physical functions,expectation of general health,and scores obtained previously(53.62±8.87 vs.61.26±9.42,44.58±12.52 vs.57.47±17.15,65.56±20.60 vs.78.18±15.73,54.38±19.73 vs.68.87±17.57,31.11±10.23 vs.41.19±66.27,44.44±27.06 vs.68.57±26.94,all P<0.05).Patients who had undergone hemodialysis for longer than 6 years won higher scores in respect to symptoms,body pain,vigour and expectation of general health(86.92±6.67,85.08±57.34,78.40±13.04,53.33±24.22,respectively),while patients who had hemodialysis for as long as 3 to 6 years won highest scores in respect to social support(94.23±10.96,all P<0.05).The level of hemoglobin and urea clearance index showed no obvious influence to MHD patients' daily life. Conclusion MHD patients have poor self-confidence and they usually lose self-confidence.Nutritional status greatly influences patients' daily life.So it is important to improve the quality of daily life in MHD patients,especially in respect of nutritional support,and this aspect should form our focus of medical support.
