MHD患者疼痛的影响因素分析

Analysis of factors influencing pain in MHD patients

目的:了解维持性血液透析(maintenance hemodialysis,MHD)患者疼痛发生的情况,探讨疼痛的现状及其影响因素。方法:选择2023年1月—2023年2月在成都三家三级综合医院血透中心的345名MHD患者进行问卷调查。采用视觉模拟评分法(visual analogue scale,VAS)、GAD-7焦虑自评量表、健康问卷抑郁自评量表(PHQ-9)、Frail量表对其进行疼痛、焦虑、抑郁、衰弱评估及问卷调查,并分析其影响因素。结果:共纳入的345名MHD患者,其中男性209例(60.6%)、女性136例(39.4%)、轻度疼痛156例(45.22%)、中度疼痛148例(42.90%)、重度疼痛41例(11.88%);MHD患者VAS总分(3.81±2.25)分、衰弱总分(2.10±1.76)分、焦虑总分(4.71±4.49)分、抑郁总分(6.63±5.84)分;有序Logistic回归分析显示,衰弱(OR=1.163,95%CI:0.008~0.294)、焦虑(OR=1.093,95%CI:0.022~0.156)、抑郁(OR=1.054,95%CI:0.001~0.105)、家庭支付医疗费用能力(OR=2.307,95%CI:0.126~1.546)是患者疼痛的主要影响因素。结论:MHD患者疼痛发生率高,衰弱、焦虑、抑郁、家庭支付医疗费用能力是MHD患者疼痛的影响因素。建议医务人员对MHD患者的疼痛情况予以及时评估,多学科个性化干预,精准护理,以提高MHD患者的生存质量。

Objective Understand the occurrence of pain in maintenance hemodialysis(maintenance hemodialysis,MHD)patients,and explore the current situation of pain and its influencing factors.Methods A total of 345 MHD patients were selected in three tertiary general hospitals in Chengdu from January 2023 to February 2023.Visual analogue scoring(Visual Analogue Scale,VAS),GAD-7 anxiety self-assessment scale,health questionnaire depression self-rating scale(PHQ-9),Frail scale for pain,anxiety,depression,weakness and questionnaire,and analyzed the influencing factors.Results VAS score of MHD patients(3.81±2.25),frailty(2.10±1.76),anxiety(4.71±4.49),and depression(6.63±5.84),and showed significant positive correlation;orderly Logistic regression analysis showed that the influencing factors of pain in MHD patients were frailty,anxiety,depression,and family ability to pay medical expenses.Conclusion High incidence of pain in MHD patients,frailty,anxiety,depression,family ability to pay for medical expenses are the influencing factors of pain in MHD patients.It is recommended that medical staff provide timely assessment of pain in MHD patients,multidisciplinary personalized intervention,and precise care to improve the quality of life of MHD patients.