不同维持性透析对患者乐观水平的影响

Survey on Optimistic Level of Patients with Maintenance Dialysis and the Impact of Dialysis Methods

[目的]探讨维持性透析患者的乐观水平及不同透析方式对患者乐观水平的影响.[方法]选取维持性腹膜透析（PD）患者52例（A组）,维持性血液透析（HD）患者54例（B组）及健康对照79例（C组）,测量患者透析前后乐观水平.[结果]A组的乐观分值为3.87±1.03,B组为3.91±1.07,均明显低于C组（4.29±1.10）,差异均有显著性（均P〈0.05）.自费患者乐观评分低于有医疗保险的患者.开始透析3个月以内及24个月以后,A组患者的乐观评分与B组的差异无统计学意义,在透析4~12个月,A组的乐观评分为3.38±0.92,明显低于B组4.24±0.93（P=0.028）,但透析13~24个月,A组的乐观评分增至4.33±0.82,高于B组3.14±0.90,且差异有显著性（P=0.031）.[结论]终末期肾病患者在规律透析后仍有不同程度的心理情绪障碍,HD患者与PD患者在不同透析时间段的乐观水平有差别,医护人员应针对性地进行心理辅导和治疗,提高患者的生活质量.

[Objective] To explore the optimistic level of patients with maintenance dialysis and the impact of dialysis methods. [Methods]A total of 52 patients with peritoneal dialysis（PD）（group A）, 54 patients with hemodialysis（HD） （group B） and 79 healthy controls（group C） were chosen. Optimistic level was measured before and after dialysis. [Results]The optimistic scores in group A and B were 3.87±1.03 and 3.91±1.07, respectively, which were obviously lower than that in group C（4.29±1.10）, and there were significant differ ences（All P 〈0.05）. The optimistic score in self-paid patients was lower than that in patients having medical insurance. Within 3 months after the initiation of dialysis and 24 months later, there was no significant differ-ence in optimistic score between group A and B. During the 3 to 12 months of dialysis, the optimistic score in group A was 3.38±_0.92, which was significantly lower in that in group B（4.24±0.97）. However, the score in group increased to 4.33±_0. 816, which was higher than that in group g（3.14±0.90） during the 13 to 24 months, and there was significant difference（ P=0. 031）. [Conclusion] Patients with end stage renal disease （ESRD） still have various degrees of mental and emotional disorders after regular dialysis. There is difference in optimistic score between HD patients and PD patients in the different stage. Medical personnel should take appropriate mental counseling and treatment to improve the quality of life of patients.