中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (09): 459-461.doi: 10.3969/j.issn.1671-4091.2016.09.004

• 临床研究 • 上一篇    下一篇

不同诱导透析模式对尿毒症患者心理状态及电解质的影响

刘伟1,王俭勤1,王文革1,梁耀军1,王雅1   

  1. 1. 兰州大学第二医院肾内科
  • 收稿日期:2015-10-12 修回日期:2016-07-05 出版日期:2016-09-12 发布日期:2016-09-12
  • 通讯作者: 刘伟 willmymail@126.com E-mail:willmymail@126.com
  • 基金资助:

    甘肃省技术研究与开发专项计划(1205TCYA028)

Influences of different hemodialysis induction pattern on mental state and serum electrolytes in endstage renal disease patients

  • Received:2015-10-12 Revised:2016-07-05 Online:2016-09-12 Published:2016-09-12

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摘要： 目的  比较不同诱导透析模式对尿毒症患者心理状态及电解质的影响，探讨心理状态和电解质之间可能的关系。方法选择兰州大学第二医院肾病中心2013～2014 年44 例新进入血液透析治疗的尿毒症患者，将其分为传统诱导透析组(conventional hemodialysis,CHD)、每日透析组(daily hemodialysis,DHD)各22 例。观察2 组患者诱导透析治疗期症状自评量表(symptom checklist 90，SCL-90)各项评分，以及治疗前1 日和治疗后第7 日时血清二氧化碳结合力(carbon dioxide-combining power,CO2-CP)、钠、钾、钙、磷水平。结果DHD 组的躯体化、强迫、人际关系敏感、抑郁、焦虑、恐怖、其他、总因子评分均低于CHD (t=2.528, P=0.015; t=2.570, P=0.014;t=2.057,P=0.046;t=2.391,P=0.021；t=2.389,P=0.021;t=2.634,P=0.012;t=2.451,P=0.018;t=2.616,P=0.012)。第1 日，两组患者CO2-CP、钠、
钾、钙、磷水平相当；第7 日，DHD 组血钾低于CHD 组(t=2.086,P=0.047)、血钙高于CHD 组(t=- 2.218,P=0.036)。结论在诱导透析期，每日透析能更好地改善尿毒症患者的心理状态，控制好血清钾、钙水平可能会提高患者的心理健康状态。

关键词: 每日透析, 血液透析, 心理健康

Abstract: Objective In this article we investigated the influences of different hemodialysis induction pattern on mental state and serum electrolytes in end-stage renal disease patients. We also aimed to define the relationship between mental state and serum electrolytes in these patients. Methods We analyzed 44 patients beginning to use hemodialysis for chronic renal failure in the period from 2013 to 2014. In these patients, Patients were treated with daily hemodialysis (DHD group, n=22) or conventional hemodialysis (CHD group, n= 22). Carbon dioxide combining power (CO2- CP), serum sodium, potassium, calcium and phosphorus were measured at admission day, and at seventh day after the treatment. Symptom checklist 90 (SCL-90) scores during the hemodialysis induction period were recorded. Results Scores of somzatization, obsession, interpersonal relation disturbance, depression, anxiety, horror and other items as well as the total score were lower in DHD group than in CHD group (t=2.528, P=0.015; t=2.570, P=0.014; t=2.057, P=0.046; t=2.391, P=0.021; t= 2.389, P=0.021; t=2.634, P=0.012; t=2.451, P=0.018; t=2.616, P=0.012, respectively). On admission, CO2- CP, serum sodium, potassium, calcium, and phosphorus had no differences between the two groups. At the seventh day after the treatment, serum potassium was lower in DHD group than in CHD group (t=2.086, P=0.047), and serum calcium was higher in DHD group than in CHD group (t=-2.218, P=0.036). Conclusions DHD, rather than CHD, could improve the mental state of the patients in the hemodialysis induction period. Maintenance of serum potassium and calcium within normal ranges may improve the mental state of the patients.

Key words: Daily hemodialysis, Hemodialysis, Mental Health