维持性血液透析患者睡眠质量调查及影响因素分析

Investigation on Sleep Quality of Maintenance Hemodialysis Patients and Analysis on Its Influencing Factors

目的:探讨维持性血液透析患者睡眠质量及影响因素。方法:选取2018年2月1日~2021年5月31日收治的95例维持性血液透析患者为研究对象,采用问卷调查的方法收集可能影响维持性血液透析患者睡眠质量影响因素、睡眠结构异常情况,并采用多因素Logistic回归进行多因素分析。结果:本研究75例(78.95%)患者出现睡眠结构异常,其中深慢波睡眠减少36例,睡眠潜伏期延长16例,夜间觉醒增加10例,睡眠效率下降13例。多因素分析结果显示,年龄≥60岁、焦虑、社会支持低分、透析龄≥3年、肌酐水平升高、甲状旁腺激素水平升高为睡眠结构异常的危险因素(P<0.05,P<0.01),血红蛋白水平升高为保护性因素(P<0.01)。结论:维持性血液透析患者主要以深慢波睡眠减少为主,其年龄、焦虑、社会支持等因素均可影响维持性血液透析患者的睡眠结构,提示护理人员在关注患者睡眠质量的同时应加强对患者的心理护理,增加其社会支持,正确使用促红细胞生成素,给予充足的营养支持。

Objective:To explore the sleep quality and its influencing factors in maintenance hemodialysis patients.Methods:A total of 95 cases of patients who received maintenance hemodialysis during February 1,2018 to May 31,2021 were selected for the study.A questionnaire survey was used to collect factors that may affect sleep quality and sleep structure abnormalities in maintenance hemodialysis patients.The multivariate logistic regression was used for multivariate analysis.Results:Of the patients in this study,75 patients(78.95%)had abnormal sleep structure,including 36 cases of decreased deep slow wave sleep,16 cases of prolonged sleep latency,10 cases of increased night awakening,and 13 cases of decreased sleep efficiency.The results of multivariate analysis based on univariate analysis showed that age≥60 years old,anxiety,low score of social support,dialysis age≥3 years,elevated creatinine level and elevated parathyroid excitation level were the risk factors for abnormal sleep structure,and elevated hemoglobin level was the protective factor(P<0.01).Conclusion:Maintenance hemodialysis patients are mainly deep slow-wave sleep less,the factors such as age,anxiety and social support can affect sleep structure of maintenance hemodialysis patients,prompt nursing in patients to focus on the quality of sleep at the same time should strengthen the psychological care of patients,increase their social support,proper use of erythropoietin,and adequate nutrition support.