维持性血液透析患者透析后疲劳的影响因素分析  

Influencing factors of post-dialysis fatigue in patients under maintenance hemodialysis

作　　者：曾维玲 栾中佼 吴私 赵自霞[1] 周光宇[1] 李德天[1] ZENG Weiling;LUAN Zhongjiao;WU Si;ZHAO Zixia;ZHOU Guangyu;LI Detian(Department of Nephrology,Shengjing Hospital,China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院肾内科,沈阳110004

出　　处：《中国医科大学学报》2020年第10期943-948,共6页Journal of China Medical University

摘　　要：目的探讨维持性血液透析(MHD)患者透析后疲劳的影响因素。方法随机抽取中国医科大学附属盛京医院第二血液透析中心MHD患者75例作为研究对象,采用修改版Piper疲乏量表(RPFS)评估患者疲劳严重程度,记录透析后恢复时间。根据RPFS评分三分位数将患者分为3组:1组(RPFS总分<2分)、2组(RPFS总分2~<6.5分)、3组(RPFS总分≥6.5分)。比较3组患者基本临床资料、睡眠质量以及透析前后检验指标。采用有序logistics回归法分析MHD患者透析后疲劳的影响因素。结果问卷有效回收70份,患者疲劳的发生率为78.57%。3组患者透析后恢复时间、透析间期体质量增加百分比、超滤量、透析后平均动脉压以及睡眠质量差异有统计学意义(均P<0.05)。有序logistic回归分析显示,超滤量(P=0.001)、睡眠质量(P=0.01)和透析后平均动脉压(P=0.029)与透析后疲劳有关。结论MHD患者普遍存在透析后疲劳,超滤量高、透析后平均动脉压低和睡眠质量差是透析后疲劳的危险因素。Objective To analyze the influencing factors of post-dialysis fatigue in patients under maintenance hemodialysis(MHD).Methods A total of 75 patients under MHD in the second hemodialysis center of Shengjing Hospital of China Medical University were enrolled.They were investigated using the Revised Piper Fatigue Scale(RPFS),and the time of recovery from hemodialysis was recorded.All patients were divided into three different groups according to the tertiles of the RPFS score,and clinical data,sleep quality,and indicators before and after dialysis in these three groups were compared.Influencing factors for post-dialysis fatigue in patients under MHD were analyzed using the ordinal polytomous logistic regression method.Results A total of 70 questionnaires were effectively collected.The incidence of post-dialysis fatigue was noted in 78.57%of patients under MHD.Among the three groups,the recovery time after dialysis,interdialytic weight gain,ultrafiltration volume,and mean arterial pressure after dialysis showed significant difference(all P<0.05).The logistic regression analysis showed that ultrafiltration volume(P=0.001),sleep quality(P=0.01),and mean arterial pressure after dialysis(P=0.029)were associated with post-dialysis fatigue.Conclusion Post-dialysis fatigue is a common occurrence in patients under MHD,and high ultrafiltration volume,low mean arterial pressure after dialysis,and poor sleep quality are risk factors associated with its occurrence.

关 键 词：透析后疲劳 维持性血液透析 超滤量 睡眠质量 影响因素 

分 类 号：R692[医药卫生—泌尿科学]