中国公民逝世后器官捐献者家属捐献意愿影响因素分析

A study of factors influencing family decision of Chinese donation after citizen's death

目的分析中国公民逝世后器官捐献(CDCD)者家属捐献意愿的影响因素,以便解决捐献者家属面临的问题和困难,提高潜在器官捐献者成功捐献的比例。方法 2010年3月至2015年8月,武汉大学移植医学中心肝胆疾病研究院共发现并访谈1 436例符合中国人体器官捐献Ⅰ、Ⅱ、Ⅲ类标准的潜在捐献者。根据捐献情况将潜在捐献者分为同意捐献组和拒绝捐献组,分析比较两组人群年龄、受教育程度、直系家庭成员数、家庭年收入。计量资料比较采用成组t检验,计数资料比较采用卡方检验,P<0.05为差异有统计学意义。结果 1 436例潜在捐献者中,由于肝肾功能异常、家属意见统一前捐献者死亡等他其原因导致未能捐献者201例。其余1 235例潜在捐献者中,同意捐献者204例(16.5%),拒绝捐献者1 031例(83.5%)。204例同意捐献者中,194例成功捐献,早期在外院转运途中抢救无效死亡来不及捐献10例。拒绝捐献者原因分别为:部分直系家属不同意捐献(或原因不明)434例(42.1%);明白器官捐献社会意义但因不忍亲人逝世后手术而拒绝捐献366例(35.5%);因传统观念较重而拒绝捐献231例(22.4%)。同意捐献组平均年龄(44±17)岁,低于拒绝捐献组平均年龄(50±18)岁(t=-4.39,P<0.05)。同意捐献组受教育程度低于拒绝捐献组(χ2=194.78,P<0.05),两组男女比例差异无统计学意义(χ2=0.35,P>0.05)。194例成功捐献者死亡原因最主要为交通事故等所致严重颅脑外伤,占63.91%(124/194)。结论 CDCD工作的顺利开展需要协调员的努力,多部门、多科室的顺畅沟通合作,社会的支持和认可,弘扬爱心奉献的优秀传统,普及器官捐献知识,加强器官捐献相关法律法规的建设并实施。

Objective Factors that influence family＇ s decision of Chinese donation after citizen＇s death（ CDCD） were analyzed to solve problems and difficulties which faced by donor families,and improve the rate of agreement to donation. Methods From March 2010 to August 2015,Zhongnan Hospital of Wuhan University discovered and interviewed 1 436 potential donors which measured up with Chinese Organ Donation Standard Ⅰ,Ⅱ,Ⅲ. The potential donors were divided into two groups based on donation situation： agreed to donate and refused to donate. Age,education level,the number of immediate family members and the family income of the two groups were compared. Results In the total 1 436 cases,201 cases were failed to donate because of liver and kidney dysfunction and death came before families consent. In the rest of potential donors,1 031 cases refused to donate（ 83. 5%）,194 among 204 cases（ 16. 5%） who agreed to donate accomplished the donation eventually. The important reason to refuse donation was the part of the lineal relatives disagree to donate（ 434,42. 1%）.The average age of group of agreed to donate was（ 44 ± 17） years,which was lower than the group of refused to donate（ 50 ± 18） years（ t = 4. 39,P〈0. 05）,and the education level was lower than the group of refused to donate（ χ2= 194. 78,P〈0. 05）. Conclusions To carry out the work of CDCD smoothly,efforts of coordinators,multi-sector cooperation,support and recognition of society were needed,good tradition of love devotion and organ donation knowledge among people should be promoted and popularized.