肝移植患者术后早期疲劳发展轨迹研究  

Study on the development track of early fatigue after liver transplantation

作　　者：席双梅 张莉莉[2] 谷艳梅[1] 郭会敏[2] 刘薪[1] 郑煜琳 金伯旬 栗光明 Xi Shuangmei;Zhang Lili;Gu Yanmei;Guo Huimin;Liu Xin;Zheng Yulin;Jin Boxun;Li Guangming(Department of Critical Care Medicine,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China;Department of Nursing,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China;Surgery Center,Beijing You'an Hospital affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院重症医学科,北京100069 [2]首都医科大学附属北京佑安医院护理部,北京100069 [3]首都医科大学附属北京佑安医院外科中心,北京100069

出　　处：《肝癌电子杂志》2024年第2期94-99,共6页Electronic Journal of Liver Tumor

基　　金：北京市医院管理中心青年人才培养“青苗”计划(QML20231704)。

摘　　要：目的:探讨肝移植患者术后早期疲劳发展轨迹及其影响因素。方法:纳入2019年1月至2023年3月于首都医科大学附属北京佑安医院肝移植中心肝移植后随访的96例患者为研究对象。采用疲劳评定量表(FAI)评估患者术后1周、2周、1个月、3个月、6个月疲劳情况,并采用增长混合模型(LGMM)分析识别肝移植术后患者早期疲劳发展轨迹;并采集患者一般资料、社会支持、心理状态等资料对早期疲劳发展轨迹的影响进行多因素Logistic回归分析。结果:96例在肝移植术后患者6个月的随访中均有完整FAI评分共91例,最终纳入91例患者。LGMM分析显示肝移植术后患者早期疲劳发展趋势分为3个类型,分别为下降组(36例)、稳定组(34例)、升高组(21例);3个组别的疲劳发展均有时间效应,下降组FAI评分随时间显著降低,稳定组随时间无显著变化,升高组随时间显著升高。多因素Logistic回归分析显示年龄、焦虑、抑郁、睡眠状态及社会支持水平是肝移植术后患者早期疲劳发展轨迹的影响因素(P<0.05)。结论:肝移植术后患者早期疲劳发展轨迹具异质性,存在不同类别的发展趋势,其中年龄、焦虑、抑郁、睡眠状态及社会支持水平是其影响因素。Objective:To explore the development track of early fatigue after liver transplantation and its influencing factors.Methods:96 liver transplant patients who were followed up in the liver transplant center of our hospital from January 2019 to March 2023 were selected as the research objects.Fatigue assessment scale(FAI)was used to evaluate the fatigue of patients at 1 week,2 weeks,1 month,3 months and 6 months after liver transplantation,and growth mixed model(LGMM)was used to analyze and identify the early fatigue development track of patients after liver transplantation.The general data,social support and psychological state of patients were collected,and the influencing factors of patients'early fatigue development track were analyzed by multi-classification Logistic regression.Results:During the 6-month follow-up,there were 91 patients with complete follow-up data of FAI scale,and finally 91 patients were included.LGMM analysis showed that the early fatigue development trend of patients after liver transplantation was divided into three types,namely,descending group(n=36),stable group(n=34)and ascending group(n=21).The fatigue development of all three groups had a time effect.The FAI score of descending group decreased significantly with time,while that of stable group did not change significantly with time,while that of ascending group increased significantly with time.Logistic regression analysis showed that age,anxiety,depression,sleep status and social support level were the influencing factors of early fatigue development after liver transplantation(P<0.05).Conclusion:The development track of early fatigue in patients after liver transplantation is heterogeneous,and there are different types of development trends,among which age,anxiety,depression,sleep state and social support level are the influencing factors.

关 键 词：肝移植 疲劳 发展轨迹 影响因素 增长混合模型 

分 类 号：R657.3[医药卫生—外科学]