中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (06): 367-370.doi: 10.3969/j.issn.1671-4091.2016.06.013

• 临床研究 • 上一篇    下一篇

腹膜透析患者生活质量的相关影响因素分析

刘莹,韩庆烽,唐雯,孙玲华,史春迎,聂建东,孙庆华   

  1.  北京大学第三医院肾内科
  • 收稿日期:2015-07-17 修回日期:2016-04-13 出版日期:2016-06-12 发布日期:2016-06-19
  • 通讯作者: 韩庆烽 hanqingfeng@sina.com E-mail:hanqingfeng@sina.com

The quality of life and its related factors in peritoneal dialysis patients

  • Received:2015-07-17 Revised:2016-04-13 Online:2016-06-12 Published:2016-06-19

RichHTML

0

PDF

239

摘要： 目的分析北京大学第三医院腹膜透析患者的生活质量及其相关因素，为提高腹膜透析患者的生活质量提供理论依据。方法使用健康状况问卷简表(the MOS 36-Item Short-Form Health Survey,SF-36)对腹膜透析患者的生活质量进行现况调查，比较不同腹膜透析患者的生活质量，评估腹膜透析状况、合并症情况、生化指标等与腹膜透析患者的生活质量的关系。结果93 例腹膜透析患者生活质量躯体健康总分(physical components score，PCS)为59.4(43.4～74.8)，精神健康总分(mental
components score，MCS) 为68.2(51.9～78.8)。不同性别(PCS：χ2=1.643，P=0.100；MCS：χ2=1.651，P=0.099)、婚姻状况(PCS：χ2=0.751，P=0.453；MCS：χ2=1.403，P=0.161)、医疗报销比例(PCS：χ2=-0.182，P=0.855；MCS：χ2=0.235，P=0.814)、家庭居住环境(PCS：χ2=1.340，P=0.180；MCS：χ2=1.450，P=0.147)及文化水平分层(PCS：χ2=1.548，P=0.461；MCS：χ2=3.254，P=0.197)的患者，生活质量无统计学差异。自我照顾者与依赖他人照顾者的PCS、MCS 上有统计学差异(PCS：t=-2.293，P=0.022；MCS：t=-2.393，P=0.017)。腹膜透析状况各指标与生活质量无显著相关(尿量与PCS：r=0.190，P=0.067；尿量与MCS：r=0.160，P=0.125；残余肾Kt/V 与PCS：r=-0.082，P=0.437；残余肾Kt/V 与MCS：r=-0.104，P=320)。合并症指数(B=-2.409，t=-2.132，P=0.036)、血浆白蛋白(B=1.435，t=2.768，P=0.007)是腹膜透析患者生活质量的独立影响因素。结论合并症指数、血浆白蛋白是腹膜透析患者生活质量的独立影响因素。通过有效的腹膜透析管理体系，提高患者的自我管理能力，综合处理多种合并症，对提高腹膜透析患者生活质量可能发挥一定的作用。

关键词: 腹膜透析, 生活质量, 自我管理, 合并症

Abstract: Objective To analyze the factors relating to the quality of life in peritoneal dialysis (PD) patients treated in Peking University Third Hospital. Methods SF-36TM survival quality assessment scale was used in this cross-sectional study. Quality of life was assessed and compared among different patient groups. Dialysis adequacy, Charlson comorbidity index (CCI) and biochemical parameters were analyzed to assess their relevance to quality of life in PD patients. Results In the 93 PD patients, physical components score (PCS) was 59.4 (43.4～74.8), and mental components score (MCS) was 68.2 (51.9～78.8). Patients with different gender, marriage situation, medical reimbursement ratio, live condition, and educational level had no significant differences in quality of life, while patients who live on themselves and those who must rely on others were different in PCS and MCS. Dialysis condition parameters had no relevance to quality of life in PD patients. CCI and serum albumin were the independent risk factors for quality of life in PD patients. Conclusion CCI and serum albumin were the independent risk factors for quality of life in PD patients. These results suggest that improvement of self-management skills and treatment of comorbidities may have a positive effect on quality of life in PD patients.

Key words: Peritoneal Dialysis, Quality of life, Self-management, Comorbidity