腹膜透析患者依从性自评及与预后的相关性分析  

Analysis of Compliance by Self-reporting and its Correlation with Outcomes Among Peritoneal Aialysis Patients

作　　者：张蓓茹[1] 于锐[1] 吴岩[1] 田密[1] 白瑜[1] 李德天[1] 

机构地区：[1]中国医科大学附属盛京医院肾脏内科,辽宁沈阳110004

出　　处：《医学临床研究》2015年第3期420-423,共4页Journal of Clinical Research

基　　金：辽宁省自然科学基金

摘　　要：【目的】采用自评方式评估腹膜透析患者的依从性、分析依从性相关因素以及与患者预后的相关性。【方法】对腹膜透析患者的饮食、液体、药物及腹膜透析治疗方案的依从性采用自评方式进行评估，同时分析依从性相关因素以及对患者预后的影响。【结果】共有94例患者参加自评。患者对药物和治疗方案依从性好的患者分别达到78．73％和82．98％，而对饮食和液体的依从性好的患者仅有56．39％和61．63％。年龄、受教育程度、是否仍从事工作、腹膜透析操作方式以及腹透时间对依从性有影响。而且依从性好组患者的住院率明显低于依从性坏组（ P ＜0．001），但两组腹膜炎发生率相比较差异无统计学意义（ P ＝0．328）。【结论】自评方式可以做为依从性评估的有效方法，腹膜透析患者对饮食、液体、药物及腹膜透析治疗方案依从性不同，受多种因素影响，且依从性与患者预后相关。应定期对患者采取自评方式评估依从性，针对不同人群进行个体化宣教，采取有效干预措施提高患者依从性，进而改善患者预后。[Objective] To evaluate the compliance by self‐reporting ,correlative factors and its correlation with outcomes among peritoneal dialysis （PD） patients .[Methods] The levels of compliance in four compo‐nents of therapeutic regimens ,i .e .fluid restriction ,medication and dialysis regimen ,were evaluated by self‐reporting .[Results] A total of 94 cases were enrolled .The compliance rates of medication and dialysis regi‐men were 78 .73% and 82 .98% respectively .However ,the compliances of diets and fluid restriction were only 56 .39% and 61 .63% respectively .Age ,education level ,employment status ,operation mode of PD and dura‐tion of PD affected the compliance .In relation to outcomes ,the incidence of hospitalization was higher in poor compliance group than that in good compliance group （ P〈0 .001） .However ,no inter‐group difference exis‐ted in peritonitis rate （ P =0 .328） .[Conclusion] Self‐reporting may be a effective method of evaluating the compliance .The compliances of diets ,fluid restriction ,medication and dialysis regimen vary among PD pa‐tients .There are many influencing factors .Moreover ,the compliance is associated with outcomes .As a re‐sult ,we should evaluate compliance by self‐report regularly ,provide individualized counseling and take effec‐tive measures of improving so as to further improve the outcomes of PD patients .

关 键 词：腹膜透析 病人依从 预后 干预性研究 

分 类 号：R459.51[医药卫生—治疗学]