维持性血液透析患者的生存质量评价及相关因素分析

发布时间：2018-02-02 15:27

本文关键词： MHD 生存质量 KDQOL-SF　出处：《广西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景：随着血液透析的广泛运用,维持性血液透析(maintenance hemodialysis MHD)患者的预期寿命明显延长,但MHD患者较低生存质量的研究屡有报道。本次研究探讨与MI1D患者生存质量相关的因素,为改善和提高MHD患者的生存质量提供依据。方法：选取从2016年3月12日到3月20日,在广西医科大学第一附属医院血液净化中心治疗的维持性血液透析的患者,收集的数据包括社会人口资料,病例资料,血液净化治疗方案和实验室结果,使用KDQOL-SF评估患者的生存质量。KDQOL-SF量表其中包括一般健康生存质量量表(SF-36)及肾病、透析相关生存质(KDTA)量表。SF-36包括心理相关生存质量(MCS)及生理相关生存质量(PCS)两个方面。结果：KDTA的总分为55.99±8.90。SF-36的总分为47.08±12.03,而PCS总分和MCS总分分别为48.93±16.96和46.67±14.78。KDTA独立相关因素有年龄(B=-0.23、P=0.00)、白蛋白(B=0.55、P=0.00)、对尿毒症的认识(B=5.17、P=0.00)、透析病程(B=-0.92、P=0.00)、家庭收入(B=1.30,P=0.00)、教育程度(B=2.26、P=0.00)、透析频次(Exp(B)=-1.61、p=0.01)。PCS的独立相关因素有年龄(B=-0.54、P=0.00)、性别(B=7.19,P=0.01)、透析病程(B=-0.89、P=-0.00)、超敏C反应蛋白(B=-0.38、P=0.04)。MCS的独立相关因素为年龄(B=-0.36、P=-0.00)、性别(B=-8.03、P=-0.00)、是否患糖尿病(Exp(B)=-4.08、p=0.01)、血红蛋白(Exp(B)=0.959、p=0.037)。结论：社会人口因素和临床因素都会影响广西MHD患者的生存质量,社会人口因素包括性别、年龄、家庭收入、教育水平。临床因素包括低白蛋白血症、透析病程、处于炎症状态、对尿毒症的认识、透析频次、血红蛋白及是否患有糖尿病。对生存质量低的患者需要医护人员更多的关注,社会给予更多的支持。其中包括社会支持、更加完善的医疗及营养支持等,以减少进一步的健康并发症,提高广西MHD患者的质量。
[Abstract]:Background: with the widespread use of hemodialysis, life expectancy in patients with maintenance hemodialysis maintenance hemodialysis MHD is significantly prolonged. However, the study of low quality of life in patients with MHD has been reported frequently. This study is to explore the factors related to the quality of life of patients with MI1D. Methods: from March 12th 2016 to March 20th. Data collected from maintenance hemodialysis patients treated at the Blood purification Center of the first affiliated Hospital of Guangxi Medical University include socio-demographic data, case data, blood purification treatment programs and laboratory results. KDQOL-SF was used to evaluate the quality of life (QOL) of patients with KDQOL-SF, including SF-36) and nephropathy. Analysis of the KDTA-related quality of Survival scale SF-36 including psychologically related quality of Life (MCSs) and Physiological-Related quality of Life (PCS). Results the total score of KDTA was 55.99 卤8.90.SF-36 and the total score was 47.08 卤12.03. The total score of PCS and MCS were 48.93 卤16.96 and 46.67 卤14.78 respectively. The course of dialysis was B ~ (-0.92) (P ~ (0.00)), and the course of dialysis was B ~ (-0.92) / P ~ (0.00) (B _ (5.17) P ~ (0.00)). Family income is 1.30%, education level is 2.26%, and dialysis frequency is -1.61. The independent correlation factors of p0. 01 and PCS were: age, age, age, sex, sex, and course of hemodialysis, respectively. The independent correlation factors of P0. 00- 0. 00G, BX-0. 38A, P0. 04N. MCS were: age-0. 36%-0. 36%-0. 00) (P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05). Male and female patients were diagnosed as having diabetes mellitus (P < 0.01) and hemoglobin (P < 0. 959, P < 0. 959), if they had diabetes mellitus (P < 0. 003), whether they were suffering from diabetes mellitus (P = 0. 009) or not (P = 0. 01). Conclusion: Socio-demographic factors and clinical factors will affect the quality of life of patients with MHD in Guangxi. The socio-demographic factors include gender, age and family income. Educational level. Clinical factors include hypoalbuminemia, course of dialysis, inflammation, knowledge of uremia, frequency of dialysis. Hemoglobin and diabetes mellitus. Patients with low quality of life need more attention from health care workers, more social support, including social support, better medical and nutritional support, and so on. In order to reduce further health complications and improve the quality of patients with MHD in Guangxi.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R692.5

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