老年血液透析患者衰弱现况

Frailty status of elderly hemodialysis patients

目的通过Tiburg衰弱指数方法研究老年血液透析患者衰弱现况,并分析相关影响因素,为提高老年血液透析患者生活质量和延长生存期提供依据。方法采用方便抽样法和老年人衰弱评估量表,以2018年1月-3月本市3所三甲医院183例在肾内科住院后,转来本院进行血液透析的老年患者作为研究对象,对患者的生理、心理、社会、认知及环境5个维度进行调查并分析,评价其衰弱情况。结果老年血液透析患者的衰弱总均分为(14.07±2.97)分,其中有41.5%的患者可判定为衰弱,以生理方面的衰弱最为突出,其次为认知方面的衰弱较为突出。与非衰弱患者比较,衰弱患者IL-6、CRP、中性粒细胞及WBC水平显著升高,血红蛋白水平显著下降,差异均有统计学意义(P<0.05)。结论老年血液透析患者存在较高衰弱风险,应针对衰弱的影响因素从多方面进行干预和治疗,减少其并发症和死亡率,提高患者的生活质量和延长寿命。

Objective Tiburg frailty index method was used to study the frailty status of elderly hemodialysis patients and analyze relevant influencing factors,so as to provide basis for improving the quality of life and extending the survival period of elderly hemodialysis patients.Methods Using convenience sampling method and senile weakness assessment scale,183 elderly patients who were transferred to our hospital for hemodialysis after hospitalization in the Department of Nephrology from January to March 2018 were investigated and analyzed from five dimensions of physiology,psychology,society,cognition and environment to evaluate their frailty.Results The total score of frailty in elderly hemodialysis patients was 14.07±2.97,and41.5%patients of which could be judged as frailty,with the most prominent physiological frailty,followed by the most prominent cognitive frailty.The levels of IL-6,CRP,neutrophil and WBC were significantly increased,and the levels of hemoglobin decreased significantly(P<0.05).Conclusion Elderly hemodialysis patients have a higher risk of frailty,so intervention and treatment should be carried out from various aspects according to the factors affecting frailty,so as to reduce its complications and mortality,improve the quality of life of patients and prolong life.