维持性血液透析患者的心理状态分析

Psychological analysis of hemodialysis patients

目的:对维持性血液透析病人的心理状态进行分析,探讨其相关因素。方法:采用SCL-90自评量表、Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS),对234例维持性血透病人进行心理状态的调查分析。结果:维持性血透患者的SCL-90总分、总均分、阳性项目数及躯体化、抑郁、焦虑、恐怖、其它(睡眠、饮食)因子分均明显高于国内常模(P<0.05);160例(68.38%)发生抑郁的患者年龄、透析充分性指标Kt/V均明显低于非抑郁组(P<0.05),而血红蛋白(Hb)、血肌酐(Scr)、尿素氮(BUN)、C反应蛋白(CRP)水平均显著高于非抑郁症组(P<0.05);47例(20.9%)发生焦虑的患者Kt/V明显低于无焦虑状态组(P<0.05),而Scr、BUN、CRP水平均明显高于无焦虑状态的患者(P<0.05)。结论:维持性血透患者存在较多的心理问题,应引起社会足够重视,积极进行心理疏导,以提高患者的生存质量。

Objective： To analyze the psychological barriers of patients on maintenance hemodialysis to explore its associated factors.Methods： 234 cases of maintenance hemodialysis patients from six hemodialysis centers through Shanghai Pudong New Area,were analyzed of psychological state using rating scale method（SCL-90 Symptom Checklist for clinical,Zung Self-Rating Anxiety Scale（SAS） and Zung self-assessment table（SDS））.Results： Most hemodialysis patients had varying degrees of psychological problems,with higher SCL-90 total score,total average,somatization,depression,anxiety,terror,and other（sleeping,eating） factor scores than in the national norm（P0.05）,the incidence of depression among 234 cases was 160 cases（68.38%）,and the study found those patients were younger than non-depressed patients（P0.05） as well as lower hemoglobin level,serum creatinine,urea nitrogen,CRP,Kt/V（P0.05）.47 cases（20.9%） had anxiety,who had higher serum creatinine,BUN,Kt/V,CRP levels（P0.05）.Conclusion： Hemodialysis patients have more psychological problems,which needs attention,psychological counseling to improve the quality of life in hemodialysis patients.