心理干预对维持性血液透析患者影响的随机对照研究

Psychological Intervention on the Maintained Hemodialysis Patients:A Randomly Controlled Study

将77例维持性血液透析患者随机分为干预组或对照组。对照组接受常规的血液透析并按医嘱服用重组人促红细胞生成素(rhEPO);干预组在此基础上,还接受渐进性肌肉放松训练和脑波同步治疗。采用SCL-90量表和SF-36问卷,在干预前、后3天内分别对两组进行测量,同时检测血常规、肾功能及透析间期体重增加量与干体重的比值(IWGR%)。70例患者(干预组36例,对照组34例)完成了实验。结果发现,经过心理干预,干预组的心理健康状况、总体生活质量、血红蛋白(HB)、红细胞计数(RBC)、红细胞压积(HCT)以及透析前血清钙(Ca2+)显著高于对照组;透析前血清尿素氮(BUN)、磷(PO34-)、钾(K+)水平以及透析间期体重增加量与干体重的比值(IWGR%)显著低于对照组;两组透析前的血清肌酐(Scr)差异无显著性意义。

To study whether psychological intervention can improve maintained hemodialysis （MHD） patients＇ mental state, increase their compliance to treatment, and mend their physiological function and quality of life, seventy-seven MHD patients were randomly assigned to the intervention group （39 patients） or the control group （38 patients）. The control group received the conventional therapy which included hemodialysis 3 times/week and recombinant human erythropoietin （rHuEPO） at dosages of 100 unites/（kg·week^-1） to 150 unites/（kg·week^-1） by i. v and subcutaneous injection. The intervention group received the conventional therapy combined with psychological intervention, which included brainwave synchronizer and progressive relaxation. Thirty-six patients of the intervention group and 34 patients of the control group completed the study. Psychological variables and hematic parameter in both groups were assessed three days before and after the intervention. The patients who received psychological intervention therapy showed better mental state, higher global quality of life and higher values of HB, RBC, HCT and serum calcium, lower values of serum phosphor, kalium, BUN and IWGR% than those in the control group. There is no significant difference in serum Scr between both groups.