疼痛对长期血液透析患者生活质量的影响

Impact of pain on the quality of life in long-term hemodialysis patients

目的了解长期血液透析患者疼痛状况及其对生活质量的影响。方法选择北京协和医院维持性血液透析5年以上患者33例,平均年龄(60.7±9.6)岁,平均透析龄为(9.5±3.9)年(5～17年)。收集患者一般临床资料,用简明疼痛问卷(brief pain inventory,BPI)调查,了解疼痛原因、性质、程度和部位,及其对生活的影响;用SF-36健康调查量表调查患者生活质量。结果本组患者疼痛的发生率为75.8%,主要疼痛部位:肩(51.5%)、膝(36.4%)、腕(18.2%)、髋(15.2%)。自我疼痛程度评分为(3.7±1.9)分(0～10分),24.2%的患者需要长期服用止痛药来缓解疼痛。疼痛的程度和部位与患者的年龄、性别、原发病、透析时间、K t/V、血钙、血磷、甲状旁腺激素和血红蛋白没有关系。疼痛患者SF-36健康调查量表多方面得分均低于非疼痛患者。结论长期透析患者慢性疼痛发生率高,严重影响其生活质量,值得关注。

Objective To study the association between pain and life quality in patients with long-term hemodialysis. Methods A total of 33 patients with hemodialysis for more than 5 years from Peking Union Medical College Hospital were selected. The mean age of these patients was 60.7±9.6 years old. The average HD period was 9.5±3.9（5-17）years. The general conditions and biochemical data were collected. Brief Pain Inventory evaluated the pain. SF-36 scales assessed their life quality. Results 75.8% patients had chronic pain. The usually affected parts were shoulder （51.5%）, knee （36.4%）, wrist （18.2%） and hip （15.2%）. The average pain scale was 3.7±1.9 （numerical scale 0-10）. 24.2% patients were receiving anti-inflammatory drugs. There were no demographic, serological, and dialysis-related predictors for pain （such as age, primary disease, hemodialysis period, Kt/V, Ca, P, PTH and Hb）. Patients who complained of pain got less scaled scores of SF-36 （P0.05）. Conclusion Pain was a significant problem for long-term HD patients and affected the quality of life. Nephrologists should pay more attention on it.