心力衰竭患者口渴痛苦感现状及影响因素分析

Status quo of thirst distress in patients with heart failure and its influencing factors

目的了解心力衰竭患者口渴痛苦感现状并分析其影响因素,为干预措施的制订提供依据。方法采用便利抽样法,于2018年8—12月选取江苏省、河南省3家三甲医院的445例心力衰竭患者作为研究对象,采用一般资料调查表、心力衰竭口渴痛苦量表(TDS-HF)、明尼苏达生活质量问卷(MLHFQ)、24 h出入量记录表对其进行调查,并对心力衰竭患者口渴痛苦感的影响因素进行分析。结果共发放问卷及出入量记录表445份,有效回收401份。慢性心力衰竭患者的TDS-HF得分为(21.98±9.70)分,MLHFQ得分为(57.77±28.34)分,两者呈正相关(r=0.146,P=0.003)。单因素分析结果显示,不同体表面积、BMI、是否饮酒、7 d液体摄入量、7 d液体排出量、7 d出入差、上午入量占比、下午入量占比、晚间入量占比、心功能、左室射血分数、估计血浆容量、是否水肿、估测肾小球滤过率的心力衰竭患者,其TDS-HF得分比较,差异有统计学意义(P<0.05)。以TDS-HF得分为因变量,以单因素分析结果中有统计学意义的变量作为自变量,进行多重线性回归分析,结果显示,患者BMI、体表面积、7 d液体摄入量、7 d出入差值、上午入量占比、下午入量占比、心功能、估计的血浆容量、水肿分级、估测肾小球滤过率是心力衰竭患者口渴痛苦感的主要影响因素(P<0.05)。结论心力衰竭患者口渴痛苦感较严重,受到限制饮水、患者个体差异性、病情等的影响。医护人员有必要根据影响因素制订针对性的干预措施,使治疗取得最佳效果的同时减轻患者口渴痛苦感,改善患者的生活质量。

Objective To explore the status quo of thirst distress in patients with heart failure and its influencing factors and to provide a basis for developing intervention measures.Methods Totally 445 patients with heart failure were selected from 3 ClassⅢGrade A hospitals in Jiangsu and He'nan Provinces by convenient sampling,and investigated with the general information questionnaire,Thirst Distress Scale-Heart Failure(TDS-HF),Minnesota Heart Failure Quality of Life Scale(MLHFQ)and 24-hour Input and Output Record between August and December 2018.The influencing factors to thirst distress in patients with heart failure were also analyzed.Results A total of 445 questionnaires were sent out,and 401 questionnaires were effectively recovered.The TDS-HF and MLHFQ scores of the patients with chronic heart disease were(21.98±9.70)and(57.77±28.34),and there was a positive correlation between the two(P=0.003).Univariate analysis revealed that there was a statistically significant difference in TED-HF scores between the patients with different body surface area,BMI,drinking alcohol or not,7 d fluid intake,7 d fluid output,7 d input-output difference,proportion of morning input,proportion of afternoon input,proportion of night input,cardiac function,left ventricular ejection fraction(LVEF),NT-proBNP,estimated plasma volume status(ePVS),with or without edema and estimated glomerular filtration rate(eGFR)(P<0.05).Multiple linear regression analysis was conducted taking TDS-HF scores as dependent variables and the statistically significant variables found in univariate analysis as independent variables.The results showed that patients'BMI,body surface area,7 d fluid intake,7 d input-output difference,proportion of morning input,proportion of afternoon input,cardiac function,ePVS,edema grading and eGFR were the main influencing factors to thirst distress in patients with heart failure(P<0.05).Conclusions The thirst distress is severe in patients with heart failure,which is affected by limited water,individual variation between patients and disease conditions.It is necessary for medical and nursing workers develop targeted intervention measures,reduce thirst distress while achieving the best outcomes,and improve the patients'quality of life.