社会回归对腹膜透析患者生活质量的影响

The Influence of Returning to Society on the Quality of Life of Patients Undergoing Peritoneal Dialysis

目的了解腹膜透析患者社会回归及生活质量状况,分析不同社会回归状况对腹膜透析患者生活质量的影响。方法2005年6月—2008年6月西安交通大学医学院第一附属医院肾内科腹膜透析门诊随访的透析时间6个月以上的患者100例。将患者社会回归状况分为4级,用健康调查简表(the MOS Item Short from Health Survey,SF-36)评估患者生活质量状况、用karnofsky活动指数评定患者活动状况、主观营养评估评价营养状况,比较不同社会回归状况患者生活质量、活动状况和营养状况的差异。结果100例门诊腹膜透析患者中,社会回归1级16例,2级42例,3级32例,4级10例。不同社会回归级别患者SF-36中生理健康、生理角色、健康总体自评、活力维度得分,以及karnofsky活动指数、主观营养评估结果差异有统计学意义。社会回归与年龄、主观营养评估呈负相关,与血红蛋白、白蛋白、Karnofsky活动指数呈正相关(P<0.05或P<0.01)。结论社会回归级别较高的腹膜透析患者,其生活质量较好。社会回归的程度受患者的营养状况、心理状况、活动能力影响,提高社会回归程度有利于改善患者生活质量。

Objective To learn about the situation of returning to the society and quality of life of patients undergoing peritoneal dialysis, and to analyze the influence of society returning of various degrees on such patients＇ quality of life. Methods 100 cases who had had peritoneal dialysis for 6 months or more were chosen as the study population. The returning to society of the patients was divided into 4 grades, their quality of life was assessed by means of SF-36, their activity situation was assessed by the application of Karnofsky activity index, and their nutritional status assessed by Subjective Global Assessment. Then a comparison was made of the quality of life, activity situation and nutritional status of patients of various degrees of society returning. Results Of the 100 cases, 16 were of Grade 1 of society returning, 42 Grade 2, 32 Grade 3, and 10 Grade 4. Among the dimensions in SF-36, the differences in the scores for physical function, role physical, general health and vitality, Karnofsky activity index, and results of Subjective Global Assessment for the patients in various grades were all statistical significant. The degree of society returning were positively correlated to the level of hemoglobin, albumin and Karnofsky activity index, while negatively correlated to age and result of Subjective Global Assessment （P〈0.05 or P〈0.01）. Conclusion The higher the grade of society returning, the better the quality of life. The degree of society returning was influenced by the patient＇s nutritional status, psychology and activity capacity. Heightening the degree of society returning is conducive to improving the patient＇ s quality of life.