维持性血液透析患者口腔健康状况及影响因素研究  

A study on oral health status and its influencing factors in hemodialysis patients

作　　者：张庆来[1] 章莹 孙倩美[1] 金美玲 何雯雯[3] ZHANG Qing-lai;ZHANG Ying;SUN Qian-mei;JIN Mei-ling;HE Wen-wen(Blood Purification Center,Department of Nephrology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;School of Nursing,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100006,China;Department of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京朝阳医院肾内科血液净化中心,北京100020 [2]中国医学科学院&北京协和医学院护理学院,北京100006 [3]中日友好医院肾病科,北京100029

出　　处：《中国血液净化》2024年第5期396-400,共5页Chinese Journal of Blood Purification

摘　　要：目的了解维持性血液透析(maintenance hemodialysis,MHD)患者口腔健康的状况并探讨患者人口社会学特征、睡眠、饮水、负性情绪对患者口腔状况的影响。方法于2023年4─8月便利选择1186名MHD患者进行问卷调查。结果①MHD患者口腔健康状况得分范围为8~22分,平均(12.54±2.63)分;②单因素分析显示:不同婚姻状况(F=4.536,P=0.004)、吸烟(F=10.768,P<0.001)、饮水情况(F=10.565,P<0.001)、医疗花费占比(F=5.308,P<0.001)、高胆固醇血症(t=-2.767,P=0.006)、冠状动脉粥样硬化性心脏病(t=-2.291,P=0.023)与MHD患者口腔健康状况存在差异;③多因素方差显示:焦虑(F=6.7634,P=0.010)、睡眠质量(F=9.374,P<0.001)、高胆固醇血症(F=4.197,P=0.041)、医疗花费占比(F=2.758,P=0.017)、吸烟(F=4.190,P=0.006)、饮水量(F=5.345,P=0.001)对口腔健康状况有显著性影响。结论MHD患者口腔健康不佳,血液透析护士应对患者的口腔健康问题保持关注,并提高MHD患者对预防性口腔保健的认识,建议针对CKD患者存在或潜在的口腔健康问题组建多学科专业团队进行管理,以进一步改善MHD患者总体健康状况。Objective To understand the oral health status in maintenance hemodialysis(MHD)patients,and to explore the impact of patients'demographic characteristics,sleep,water intake,and negative emotion on their oral health status.Methods A questionnaire survey was conducted on 1,186 MHD patients conveniently selected from April to August 2023.Results①The oral health status score of MHD patients ranged from 8 to 22 points,with an average of(12.54±2.63)points.②Univariate analysis showed that marital status(F=4.536,P=0.004),smoking(F=10.768,P<0.001),water consumption(F=10.565,P<0.001),medical expenses(F=5.308,P<0.001),hypercholesterolemia(t=-2.767,P=0.006),and coronary heart disease(t=-2.291,P=0.023)were associated with oral health status of MHD patients,and oral health status of MHD patients was negatively correlated with age(r=-0.068,P<0.05);③Multivariate analysis showed that anxiety(F=6.7634,P=0.010),sleep quality(F=9.374,P<0.001),hypercholesterolemia(F=4.197,P=0.041),proportion of medical expenses(F=2.758,P=0.017),smoking(F=4.19,P=0.006),and water intake(F=5.345,P=0.001)had significant effects on oral health.Conclusion MHD patients have poor oral health,and hemodialysis nurses should pay attention to the oral health problems of patients and improve the awareness of preventive oral health care for MHD patients.It is suggested to establish multidisciplinary professional teams to manage the existed or potential oral health problems to further improve the overall health status of MHD patients.

关 键 词：维持性血液透析 口腔健康 影响因素 护理 

分 类 号：R473[医药卫生—护理学]