血液透析与腹膜透析对尿毒症患者负性情绪及生活质量的影响

Effect of hemodialysis and peritoneal dialysis on the negative emotion and quality of life in patients with uremia

目的探讨血液透析与腹膜透析对尿毒症患者负性情绪及生活质量的影响。方法选取2012年1月至2014年10月在本院内科住院进行透析治疗的尿毒症患者126例作为研究对象,根据数字表法将患者分为血液透析组和腹膜透析组,每组63例,透析治疗1年后,分别采用抑郁自评量表评价两组患者的抑郁情况,采用焦虑自评量表评价两组患者焦虑情况,采用简明健康调查量表(SF-36)评价两组患者的生活质量,采用医学应对方式问卷评价两组患者医学应对方式,采用满意度量表评价两组患者满意度。结果透析前,两组患者抑郁和焦虑评分比较差异均无统计学意义(P>0.05),透析1年后,腹膜透析组患者抑郁评分和焦虑评分分别为(47.8±6.4)分和(45.2±7.3)分,血液透析组患者的抑郁评分和焦虑评分分别为(53.5±8.9)分和(54.6±6.9)分,与透析前比较差异均具有统计学意义(P<0.05),但腹膜透析组抑郁评分和焦虑评分均低于血液透析组,差异均具有统计学意义(P<0.05);腹膜透析组患者生理机能、健康状况、躯体疾病、精神状况、社会功能以及情感智能得分均高于血液透析组,差异均具有统计学意义(P<0.05);腹膜透析组患者的面对评分为(20.3±2.0)分,高于血液透析组的(18.5±1.7)分,回避和屈服分别为(15.9±1.5)分和(9.5±1.8)分,均低于血液透析组的(17.4±1.6)分和(11.5±2.1)分,差异均具有统计学意义(P<0.05);腹膜透析组患者的满意度为88.9%,高于血液透析组64.5%,差异具有统计学意义(P<0.05)。结论与血液透析相比,腹膜透析可以缓解患者的抑郁和焦虑情绪,提升生活质量和满意度,改善面对疾病的态度。

Objective To investigate the effect of hemodialysis and peritoneal dialysis on the negative emotion and quality of life in the patients with uremia. Methods From Jan 2012 to Oct 2014, 126 patients with uremia undergoing dialysis in our hospital were divided into hemodialysis group and peritoneal dialysis group according to random number table, with 63 patients in each group. After one year of treatment, the depression condition was evaluated using self-rating Depression Scale, and the anxiety condition was evaluated using Self-rating Anxiety Scale. The quality of life was evaluated using the 36-item Short-Form Health Survey Scale（SF-36）. Medical coping modes were evaluated by questionnaire, and the satisfaction ratio was evaluated using Satisfaction Scale. Results There was no significant difference in depression and anxiety scores between the two groups before dialysis. After one year of dialysis, the depression score and the anxiety score were（47.8±6.4） and（45.2±7.3） in the peritoneal dialysis group, and（53.5±8.9） and（54.6±6.9） in hemodialysis group, which showed statistically significant difference with those before dialysis（P〈0.01）. The scores in peritoneal dialysis group were significantly lower than those in the hemodialysis group（P〈0.01）. The physiologi-cal function, health condition, somatic diseases, mental health, social function and emotional intelligence of peritoneal dialysis group were significantly higher than those of hemodialysis dialysis group, and the differences was statistically significant（P〈0.01）. The medical coping modes score（20.3 ± 2.0） of peritoneal dialysis group were significantly higher than（18.5±1.7） of the hemodialysis group. The scores of avoidance（15.9±1.5） and yield（9.5±1.8） in peritoneal dialysis group were lower than（17.4 ± 1.6） and（11.5 ± 2.1） in hemodialysis group, and the differences were statistically significant（P〈0.05）. The satisfaction degree of the patients in peritoneal dialysis group was significantly higher than that in hemodialysis group（88.9% vs 64.5%, P〈0.05）. Conclusion Compared with hemodialysis, peritoneal dialysis can relieve depression and anxiety of patients, improve the quality of life and satisfaction, as well as improve the attitude to face the disease.