四平市某医院血液透析患者生存质量调查

发布时间：2018-04-14 04:03

本文选题：终末期肾衰竭 + 血液透析　；参考：《吉林大学》2014年硕士论文

【摘要】：终末期肾衰竭是一种不可逆的疾病。随着医疗科学技术的不断发展，血液净化设备不断更新，反渗透水处理系统的不断完善，使透析用水进一步净化，治疗技术水平不断提高以及患者对疾病的认识增加，肾衰竭患者的成活率不断提高。对于血液透析患者，治疗的目标不仅是生命的延续，他们需要一个更好的生存质量。目前透析的观念和目标是，努力提高透析患者的长期生存率；努力改善透析患者的生存质量。现阶段透析患者长期生存率已经有了明显的提高，患者可以存活10年甚至20年，随着患者生存期的延长，单一的生物医学模式已难以全面衡量疾病的治疗、护理效果，目前患者的生存质量已成为透析疗效指数更准确的评价。发达国家的欧洲和美国、日本等对维持性血液透析患者生存质量研究起步较早，进行的更多。而在中国，透析医护人员长期受传统观念影响只重视透析治疗、重视透析效能而忽视透析患者的生存质量。对维持性血液透析患者生存质量的报道国内研究较晚，开展的比较少。近几年，随着人们对生存质量的重视，相关研究已成为临床医护人员关注的焦点。但吉林省四平市尚缺乏相应的报道。目的：评估本院维持性血液透析患者的生存质量的现状及其影响因素，为提高维持性血液透析患者的生存质量提供依据。方法：①2013年1月至2014年8月期间在四平市中心人民医院接受血液透析治疗的慢性肾衰竭的尿毒症期患者400例作为研究对象。 ②采用访谈法。由接诊医生亲自对病人或患者家属进行询问，了解情况。事先设计好调查问卷，由接诊医生填写调查表。采用EXCEL2003软件建立统一数据库，由专人将调查表数据录入数据库，对每份调查表逐一审核，发现问题及时核对、更正、补缺。采用SPSS19.0软件进行统计分析。结果：本次调查发放了400份问卷，，收回有效问卷400份。其中男性234例，女性166例。原发病诊断糖尿病引起的肾病占40.3%（161例），高血压引起的肾病占31%（124例），肾小球肾炎占20.3%（81例），药物引发的肾病占5.3%（21例），其它占3.1%（13例）。患有乙型肝炎的患者占7%（28例），患有丙型肝炎的患者占8.7%（35例）。体质指数（BMI）大于或等于28的患者占17.8%（71例）。贫血的患者占63%（252例），低蛋白的患者占68.5%（274例）。本院维持性血液透析患者生存质量SF-36的总体评分为：48±15。患者的年龄、原发病、家庭里有无配偶的支持、在职情况等因素与生存质量有关。结论：1患者年龄与生存质量有关联，高年龄往往呈现低生存质量，年龄越大生理功能越差，年龄越小生理功能越好。 2就业者生存质量高于失业者。 3对于血液透析患者，家庭为主要的支持者，积极的家庭支持与患者的生存质量呈正相关系。 4我院透析患者生存质量状况不是很理想，生存质量受多种因素影响，医疗和护理人员在临床实践中除了应重视透析患者的年龄、家庭支持、工作情况等直接影响透析患者生存质量的因素外，还应关注患者的性别、家庭人均收入、体育锻炼、BMI、糖尿病病史、内瘘手术次数、血浆白蛋白水平等因素。在对透析患者的生存质量问题调查的基础上，通过有效的医疗和护理干预来提高透析患者的生存质量。
[Abstract]:End-stage renal failure is an irreversible disease. With the development of medical science and technology, blood purification equipment constantly updated, the reverse osmosis water treatment system of continuous improvement, the further purification of hemodialysis water treatment technology, and constantly improve the level of disease awareness increased in patients with renal failure, the survival rate continues to increase. For hemodialysis patients, the treatment goal is not only the continuation of life, they need a better quality of life. The dialysis concept and goal, and strive to improve the long-term survival rate of dialysis patients; to improve the quality of life in dialysis patients. At the present stage of dialysis patients long-term survival rate has been markedly improved, patients can survived for 10 years or even 20 years, along with the prolongation of survival, treatment effect, single biomedical model has been difficult to comprehensive measure of disease nursing, patient survival at present The quality evaluation of dialysis efficacy index has become more accurate. The developed countries of Europe and the United States, Japan and so on maintenance hemodialysis on quality of life in dialysis patients started earlier, the more. But in China, long-term dialysis staff affected by the traditional concept of only pay attention to the quality of life on dialysis, dialysis efficiency and ignore the importance of dialysis patients. To maintain the quality of life of patients with hemodialysis reported in domestic research later carried out less. In recent years, as people pay more attention to the quality of life, related research has become the focus of attention of the medical staff. But the Siping City of Jilin Province is lack of relevant reports.
Objective: To evaluate the quality of life and its influencing factors of maintenance hemodialysis patients in our hospital, so as to provide evidence for improving the quality of life of maintenance hemodialysis patients.
Methods: 1. From January 2013 to August 2014, 400 patients with chronic renal failure who were treated by hemodialysis in Siping Central People's hospital were selected as subjects.
The interviews were used by doctors. The patient in person or family members of patients were asked to understand the situation. The designed questionnaire, the questionnaire was filled by doctors. EXCEL2003 software was used to build a unified database, the questionnaire data for each questionnaire review, found problems in a timely manner to correct, check, fill a vacancy. SPSS19.0 software was used for statistical analysis.
Results: the survey provided 400 questionnaires, 400 valid questionnaires. There were 234 males and 166 females. The diagnosis of primary disease caused by diabetes nephropathy accounted for 40.3% (161 cases), hypertension induced nephropathy accounted for 31% (124 cases), glomerulonephritis accounted for 20.3% (81 cases), drug induced nephropathy accounted for 5.3% (21 cases), other 3.1% (13 cases). Patients with hepatitis B patients accounted for 7% (28 cases), suffering from hepatitis C patients accounted for 8.7% (35 cases). The body mass index (BMI) greater than or equal to 28 of the patients accounted for 17.8% (71 cases). Patients with anemia accounted for 63% (252 cases), low protein accounted for 68.5% of patients (274 cases). The score of SF-36 maintain the overall quality of life of patients with hemodialysis: 48 + 15. patients age, primary disease, there is no spouse to support the family, working conditions and other factors related to the quality of life.
Conclusion: the age of 1 is associated with the quality of life, the higher the age is, the lower the quality of life, the older the older the physiological function is, the smaller the age, the better the physiological function.
2 the quality of life of the workers is higher than that of the unemployed.
3 for hemodialysis patients, family as major supporters, positive family support and Cheng Zhengxiang relationship with the patient's quality of life.
4 our hospital dialysis survival condition is not ideal, the quality of life is affected by many factors, medical and nursing staff in clinical practice in dialysis patients should pay attention to the age, family support, working conditions and other direct factors that affect the quality of life in dialysis patients, but also should pay attention to patients' gender, family income, physical exercise, BMI, history of diabetes, the number of internal fistula surgery, plasma albumin level factors. Based on the quality of life survey in dialysis patients on dialysis, to improve the quality of life of patients by medical treatment and effective nursing intervention.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

【参考文献】