维持性血液透析患者症状群的确立及其与生活质量的相关性研究  

Establishment of symptom group in maintenance hemodialysis patients and its correlation with quality of life

作　　者：刘正翠[1] 游励红[1] 肖红波[1] 邹淑霞[1] 陈桂明[1] 姜蕾[1] LIU Zheng-cui;YOU Li-hong;XIAO Hong-bo;ZOU Shu-xia;CHEN Gui-ming;JIANG Lei(Blood Purification Room,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院血液净化室,深圳518036

出　　处：《中国血液净化》2018年第11期748-752,共5页Chinese Journal of Blood Purification

基　　金：北京大学深圳医院三名工程支持项目(SZSM201512034)

摘　　要：目的采用因子分析法确定维持性血液透析患者的症状群种类,并分析其与患者生活质量的相关性。方法收集183例维持性血液透析患者的一般资料,采用透析症状评估量表和简明健康状况量表(SF-36)对维持性血液透析患者症状和生活质量进行调查;通过因子分析提取维持性血液透析患者的症状群;通过Pearson相关分析探讨症状群与生活质量各维度间的相关性;采用多元线性回归分析生活质量和不同症状群间的关系。结果维持性血液透析患者同时受多种症状困扰,症状频率最高的是疲乏123(67.21%)、瘙痒116(63.39%)、皮肤干燥103(56.28%),严重程度最高的是瘙痒(3.54±0.89)、皮肤干燥(3.46±0.92)、入睡困难(3.38±0.82),对患者困扰最大的症状是疲乏(4.41±0.76)、瘙痒(4.37±1.03)、入睡困难(3.94±1.11);维持性血液透析患者生活质量总得分为(62.48±9.82)分,处于中等水平;维持性血液透析患者存在病感、情感、消化道、心肺系统及水电解质5种症状群,且症状群与患者生活质量呈负相关(5种症状群与生活质量总得分的相关性分别为r=-0.646,P=0.039; r=-0.603,P=0.028; r=-0.583,P=0.036; r=-0.571,P=0.035;r=-0.629,P=0.046);病感症状群(β=4.562,P=0.000)、情感症状群(β=3.871,P=0.000)和水电解质症状群(β=2.693,P=0.000)是维持性血液透析患者生活质量最主要的影响因素。结论维持性血液透析患者存在多个症状,受多个症状群困扰,生活质量较低。医务人员应根据症状群的特点,制定高效、综合、个体化的管理模式,进而提高患者生活质量。Objective To determine the type of symptom group in maintenance hemodialysis （MHD） patients by factor analysis method and to analyze its COlTelation with patients＇ quality of life. Methods A to- tal of 183 MHD patients were enrolled in this study. Their demographic data were collected. Symptoms and quality of life were evaluated by dialysis symptom assessment scale and concise health status scale （SF-36）. Symptom groups were extracted by the factor analysis method. The relationship between symptom group and quality of life was analyzed by Pearson COlTelation analysis, and the relationship between quality of life and different symptom groups was analyzed by multivaxiate lineax regression. Results MHD patients were plagued by various symptoms. The highest frequency of symptom was fatigue （123, 67.21%）, followed by itching （116, 63.39%） and dry skin （103, 56.28%）; the highest severity of symptom was itching （3.54±0.89）, followed by dry skin （3.46±0.92） and sleep difficulty （3.38±0.82）; the most txoublesome symptom was fatigue （4.41±0.76）, followed by itching （4.37±1.03） and sleep difficulty （3.94±1.11）. The total score of quality of life in the MHD patients was 62.48±9.82 points, being a medium level. Five symptoms groups can be delineated in MHD patients, i.e., disease feeling, emotion, digestive tract, cardiopulmonaxy system, and water and elec- trolyte. The symptom group was negatively correlated with quality of life （r=-0.646, P=0.039 for disease feeling; r=-0.603, P=0.028 for emotion; r=-0.583, P=0.036 for digestive tract; r=-0.571, P=0.035 for caxdiopul- monary system; r=-0.629, P=0.046 for water and electxolyte）. Disease feeling group （β=4.562, P=0.000）, emotional symptom group （β=3.871, P=-0.000） and water and electxolyte symptom group （β=2.693, P=0.000） were the most important factors negatively affecting quality of life in MHD patients. Conclusion MHD patients have various symptoms, which disturb them and affect quality of life. We sho

关 键 词：维持性血液透析 症状群 生活质量 相关性 

分 类 号：R459.5[医药卫生—治疗学]