肝肾移植受者392例生理和心理健康状况调查

Physical and mental health survey of liver or renal transplant recipients

目的了解我国肝、肾移植受者生理和心理健康状况，为卫生管理机构和移植中心建立受者健康管理体系提供依据。方法本研究为全国范围的横断面调查。调查对象为北京、上海、广州等9个地区的392例肝、肾移植受者。采用面对面访谈，问卷问题设计参考WHO生活质量量表（QOL—BREF）及肾脏疾病生活质量简表（KDQOL—SF）。调查内容主要包括：一般人口学信息，过去4周内的生活质量、健康状况及其影响因素，心理状况，受者需求和满意度调查等。结果392例移植受者中，肝移植受者151例，肾移植受者241例。调研结果提示：（1）生活质量调查中，回答“很好”和“好”的受者比例为62．24％，年龄对移植受者生活质量的影响具有统计学意义（X2=6．60，P〈0．05）。（2）健康状况调查中，回答“很好”和“好”的比例占69．39％。移植受者的性别、年龄、移植手术后时间、医疗保障和工作状态5个因素对移植受者的健康状况无显著影响，差异均无统计学意义（X2=0．33、3．41、1．85、0．44、0．68，均P〉0．05）。（3）心理状况调查中，长期处于负性心理状态的受者比例较少。结论我国现阶段多数肝、肾移植受者的健康状况及生活质量较好。但移植受者在生理、心理等方面的满意度与其心理预期还存在一定差距。

Objective To evaluate physical and mental health of liver or renal transplant recipients in China to provide evidence for the construction of recipients＇ health management system. Methods Three hundred and ninety-two liver or kidney transplant recipients from nine cities of China were included in this cross-sectional survey. A questionaire was designed according to the World Health Organization Quality of Life-Bref （QOL-BREF） and Kidney Disease and Quality of LifeTM Short Form（KDQOL-SF）. Demographics, quality of life （QOL） and health status over 4 weeks, mental health, and health education needs and satisfaction were recorded during face-to-face interview. Results Of 392 participants, 241 underwent liver transplantation,and 151 received kidney transplantive surgery. About 62. 2% patients considered ＂ very good＂ or ＂ good＂ QOL, which was significantly affected by age （ X2 = 6. 60, P 〈 0. 05 ） . Nearly 69.4% recipients reported ＂very good＂ or ＂good＂ health status. Gender,age,post-operation time, medical insurance and work status seemed to play no significant impacts on the health status of the subjects （X2 values were 0. 33,3.41,1.85,0.44 and 0.68, respectively ; all P 〉 0. 05 ）. Only a small number of the recipients showed long-term negative state of mind. Conclusions Our survey suggests that health status and QOL are considerably improved in majority of solid organ transplant recipients in mainland of China. However, a gap between medical or social satisfaction and mental expectation still exists to some extent among this population.