超纯透析对长期深静脉置管维持性血液透析患者导管相关性感染及情绪与生活质量的影响

Impact of ultrapure dialysis on catheter-related bloodstream infection,emotion and quality of life of long-term deep venous catheterization maintenance hemodialysis patients

目的分析超纯透析对长期深静脉置管维持性血液透析患者导管相关性血流感染(CRBSI)及情绪与生活质量的影响。方法选取2016年1月-2016年12月于医院采用长期留置血液透析导管治疗的100例患者为研究对象,随机分为对照组与试验组,各50例。对照组采用常规透析液进行透析,试验组患者采用超纯透析液进行透析。比较两组患者干预前后焦虑(SAS)、抑郁(SDS)情绪,皮肤瘙痒评分、生活质量评分及CRBSI发病率情况。结果治疗前,两组患者SAS、SDS及皮肤瘙痒及生活质量评分差异无统计学意义;治疗6个月,两组患者SAS、SDS均降低,且试验组SAS、SDS及皮肤瘙痒评分分别为(39.13±0.71)、(39.73±0.52)及(3.62±0.91)分低于对照组(P<0.05);治疗后6个月试验组生理职能,情感职能,社会功能,精神健康评分分别为(18.62±1.41)、(19.14±1.90)、(19.21±1.63)、(18.94±1.53)分高于对照组(P<0.05);试验组CRBSI发病率0低于对照组的6.00%(3/50)(P=0.241)。结论超纯透析可有效避免血液透析患者出现皮肤瘙痒现象,降低患者焦虑、抑郁不良情绪,提高患者生活质量,未能在预防维持性血液透析患者导管相关性感染方面出现优势。

OBJECTIVE To study the impact of ultrapure dialysis on catheter-related bloodstream infection（CRBSI）on emotion and quality of life of long-term deep venous catherization maintenance hemodialysis patients.METHODS A total of 100 patients who were treated with long-term indwelling hemodialysis catheter from Jan 2016 to Dec 2016 were recruited as the study objects and randomly divided into the control group and the experimental group,with 50 cases in each group.The control group was treated with conventional dialysis,while the experimental group was treated with ultrapure dialysis.The self-rating anxiety scale（SAS）,self-rating depression scale（SDS）,skin itching score,quality of life score and incidence of CRBSI were observed and compared between the two groups of patients before and after the intervention.RESULTS There were no significant differences in the SAS,SDS,skin itching score and quality of life score between the two groups of patients before the treatment.The SAS,SDS and skin itching score of the two groups of patients were reduced after the treatment for 6 months;the SAS and SDS of the experimental group were respectively（39.13±0.71）,（39.73±0.52）and（3.62±0.91）,significantly lower than those of the control group（P〈0.05）.The scores of physiological function,emotional function,social function and mental health of the experimental group were respectively（18.62±1.41）,（19.14±1.90）,（19.21±1.63）and（18.94±1.53）after the treatment for 6 months,significantly higher than those of the control group（P〈0.05）.The incidence rate of CRBSI of the experimental group was 0,lower than 6.00% of the control group（P=0.241）.CONCLUSION The ultrapure dialysis may effectively prevent the skin itching,reduce the incidence of anxiety and depression and improve the quality of life of the hemodialysis patients but fail to prevent the CRBSI in the maintenance dialysis patients.