中国血液净化 ›› 2021, Vol. 20 ›› Issue (07): 493-497.doi: 10.3969/j.issn.1671-4091.2021.07.007

• 临床研究 • 上一篇    下一篇

陕西省维持性血液透析患者透析现状及症状困扰的调查研究

朱亚杰1,辛霞2,高菊林2,王宁宁1,王莉莹1   

  1. 1延安大学医学院
    2西安交通大学医学院第一附属医院血液净化科

  • 收稿日期:2020-12-22 修回日期:2021-05-17 出版日期:2021-07-12 发布日期:2021-07-21
  • 通讯作者: 高菊林 469904109@qq.com E-mail:469904109@qq.com
  • 基金资助:
    西安交通大学第一附属医院科研发展基金(2020HL-02)

Investigation of dialysis status and symptoms in 1,012 maintenance hemodialysis patients in Shanxi Province

  1. 1Yan’an University, Yan’an 716000, China;  2Department of Blood Purification, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
  • Received:2020-12-22 Revised:2021-05-17 Online:2021-07-12 Published:2021-07-21
  • Contact: jul-in GAO E-mail:469904109@qq.com
  • Supported by:
    Institutional Fundation of the First Affiliated Hospital of Xi'an Jiaotong University

摘要: 【摘要】目的了解陕西省维持性血液透析(maintenance dialysis,MHD)患者的透析现状及症状困扰程度并分析相关影响因素。方法在2020 年10~12 月通过采取查阅病历和问卷调查相结合的方法,对陕西省MHD 患者进行调查,调查内容包括一般人口学资料、合并疾病及透析相关资料,采用症状量表(dialysis symptom index,DSI)评定症状困扰程度。结果陕西省1012 例MHD 患者中,以男性为主占65.6%,40 岁以上患者占64.7%;透析患者原发病因前3 位分别为高血压肾损害(28.7%)、慢性肾小球肾炎(19.9%)和糖尿病肾病(18.7%);血管通路主要为自体动静脉内瘘(89.3%),透析龄<5 年占45.3%,透析次数5 次/2w 占42.2%;血钙、血磷、甲状旁腺激素(parathyroid hormone,PTH),三者的达标率分别为50.1%、45.8%和29.9%。MHD 患者症状困扰发生率为35.1%~81.1%,症状困扰总得分为(57.10±20.09)分;不同的居住地(H=25.041, P<0.001)、文化程度(H=9.414, P=0.024)、月收入水平(H=7.816, P= 0.021)、血钙(H=31.138, P<0.001)、磷(H=33.784, P<0.001)、PTH(H=45.365, P<0.001)的患者症状困扰差异有统计学意义(P<0.05)。结论陕西省MHD 患者以中老年人群为主,血液透析患者前3 位原发病因依次为高血压肾损害、慢性肾小球肾炎、糖尿病肾病,自体动静脉内瘘使用比例较高,血磷、甲状旁腺激素控制不理想。MHD 患者普遍经历多种症状困扰,症状的发生受诸多因素的
影响。

关键词: 维持性血液透析, 症状困扰, 现状调查

Abstract: 【Abstract】Objective To understand the current status and its influencing factors of dialysis and symptom distress in maintenance hemodialysis (MHD) patients in Shaanxi Province. Methods During October to December, 2020, a total of 1,012 MHD patients treated in Shaanxi Province were investigated using a combination of medical records and questionnaires, including demographic data, complications, and dialysis-related information. The degree of symptom distress was assessed by the Dialysis Symptom Index (DSI). Results Among the 1,012 MHD patients in Shaanxi Province, 65.6% were males, and 64.7% were over 40 years old. The top 3 primary causes of the MHD patients were hypertension (290 cases, 28.7%), chronic glomerulonephritis (201 cases, 19.9%), and diabetic nephropathy (189 cases, 18.7%). The main blood access method was autologous arteriovenous internal fistula (89.3%). Dialysis age <5 years was in 45.3% patients, and 5 times/2 weeks of dialysis was performed in 42.2% patients.
The compliance rates of serum calcium, phosphorus and parathyroid hormone (PTH) were 50.1%, 45.8% and 29.9% respectively. The incidence of symptom distress ranged from 35.1% to 81.1% in the 1,012 MHD patients, with a total symptom distress score of (57.10±20.09). There was a statistically difference in symptom distress among patients with different residence place (H= 25.041, P<0.001), educational level(H=9.414, P=0.024), income(H=7.816, P=0.021), and levels of serum calcium(H= 31.138, P<0.001), phosphorus (H=33.784, P<0.001) and PTH(H=45.365, P<0.001) (P<0.05). Conclusion Most MHD patients in Shanxi Province were middle and old age person. The top 3 primary causes of the MHD patients were hypertension, chronic glomerulone-phritis and diabetic nephropathy. Arteriovenous internal fistula was the main blood access route. The compliance rates of serum calcium, phosphorus and PTH were lower. A variety of symptoms distressed most MHD patients, and the presence of symptoms was influenced by many factors.

Key words: Maintenance hemodialysis, Symptom distress, Current status survey

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