肝移植和肾移植受者生存质量的调查分析

Investigation on quality of life among liver and kidney transplant recipients

目的 探讨肝、肾移植术后受者生存质量（quality of life,QOL）的影响因素.方法 在5所三甲医院开展了多中心的横断面调查,选取2015年3月～2015年12月随访的153例肝移植受者和301例肾移植受者开展问卷调查,采用课题组编制的肝移植、肾移植受者生存质量量表及一般情况调查表对受者生存质量进行测评.结果 肝、肾移植受者生存质量均在不同婚姻状况、职业分组上表现出显著差异,离异、失业及低学历受者生存质量较差（P＜0.05）;与非亲属活体移植组相比,亲属活体移植受者生存质量状况更好（P＜0.05）;术后有并发症或出现排斥反应的受者生存质量总分显著低于未出现并发症或排斥反应的受者（P＜0.01）;术后时间与生存质量呈现显著正相关,受者生存质量在术后不同生存期上有存在差异（P＜0.01）.回归分析结果显示,文化程度、婚姻状况、术后时间、供者类型、是否进行辅助性化疗是肝移植术后受者生存质量的主要影响因素,婚姻状况、术后时间、供者类型、医疗形式、术后并发症或排斥反应是肾移植术后受者生存质量的主要影响因素.结论 重视肝肾移植术后受者生存质量,把握受者特点实施科学有效的护理干预.

Objective To explore the factors associated with the quality of life （QOL） in patients after liver and kidney transplantation.Methods A multicenter cross-sectional survey was carried out in 5 Level Ⅲ Class A hospitals.153 liver transplant recipients and 301 kidney transplant recipients of outpatient clinic follow-up from March to December in 2015 were selected and investigated with a self-designed general state questionnaire,and Quality of Life Scale for Liver and Kidney Transplant Recipients which developed by our research group.Results There were significant differences in QOL total score in liver and kidney transplant recipients among groups of marital status and occupation.Divorced,unemployed and low-educated patients showed lower QOL total score than married,employed and high-educated ones （P 〈 0.05）.As compared with non-living-related transplantation group,patients undergoing living-related transplantation presented a better status in QOL total scores （P〈0.05）.The QOL total score was obviously lower in patients suffering from complications and rejection than in those without occurrence of complications and rejection （P〈 0.01）.Postoperative time was correlated positively and significantly with QOL scores,and variances existed among different stages postoperation （P 〈 0.01）.Multivariable regression analysis demonstrated that education,marital status,postoperative time,type of donor and chemotherapy were the factors influencing liver transplant recipients＇ QOL,while marital status,postoperative time,type of donor,medical care assurance,complications and rejection after operation had effect on kidney transplant recipients.Conclusion Attaching importance to QOF among liver and kidney transplant recipients,and implementing scientific and effective nursing intervention based on the characteristics of them are necessary.