不同透析方式对尿毒症患者认知功能及生活质量的影响

Influence of Three Dialysis Ways on Cognitive Function of Uremic Patients and Investigation on Quality of Life

目的:调查腹膜透析(PD)、血液透析(HD)及血液透析滤过(HDF)对尿毒症患者认知功能和生存质量的影响。方法:93例尿毒症患者,按照不同透析方式分为PD组31例,HD组32例,HDF组30例,分别调查3组患者治疗前、治疗后1月、3月及6月后的简易智力状态检查量表(MMSE)评分及肾脏疾病生存质量量表(KDQOL-SFTM)评分,评估尿毒症维持透析治疗患者的认知功能及生存质量。结果:3种透析方式在治疗6月后MMSE评分,PD组、HD组及HDF组分别为29.56±3.61、25.46±3.28及24.54±4.37,PD组高于HD组及HDF组,差异有统计学意义(P<0.05);PD组患者经PD治疗半年后KDTA所属维度高于HD组、HDF组及实施透析治疗前,差异有统计学意义(P<0.05);在SF-36各维度明显高于HD及HDF组,差异具有统计学意义(P<0.05)。结论:PD组的患者在认知功能、生活质量高于HD组、HDF组的患者。

Objective： To investigate the effects of peritoneal dialysis （ PD）, hemodialysis （ HD）, hemodiafihration （HDF） on cognitive function and quality of life of uremic patients. Methods： 93 uremia patients were divided into PD group （ n = 31 ）, HD group （ n = 32）, HDF group （ n = 30）. All patients were evaluated by mini mental state examination （MMSE） and the kidney disease quality of life scale （KDQOL-SFFM） before and 1 month, 3 months and 6 months after treatment, to evaluate cognitive function and quality of life of uremic patients. Results： Comparing three dialysis methods in half a year after treatment, MMSE scores were 29.56±3.61,25.46±3.28 and 24.54 ±4.37 respec- tively. PD group is higher than the other two groups, differences were statistically significant （P 〈 0. 05 ） ; treated by PD for half a year, the dimension of KDTA of PD group patients was higher than that of HD group, HDF group and before treatment, there were significant differences （P 〈 0.05 ） ; PD group was significantly higher than that of HD and HDF group in all SF-36 dimensions, differences are statistically significant （P 〈 0.05 ）. Conclusions： Patients in PD group are significantly improved in the aspect of cognitive function and quality of life than HD and HDF group.