维持性血液透析患者口渴现状及影响因素分析

Current situation and influencing factors of thirst in maintenance hemodialysis patients

目的 调查维持性血液透析(maintenance hemodialysis,MHD)患者口渴的现状,并探讨其影响因素。方法 采用便利抽样法选取2022年2月~5月浙江中医药大学附属杭州市中医院血液净化中心369例MHD患者作为研究对象。采用一般资料调查表、透析口渴评分量表、简明口干评分量表进行问卷调查,并测量静息非刺激性唾液流率。结果 369例MHD患者透析口渴评分量表平均(14.80±3.19)分,轻度口渴(10~15分)占64.5%、中度口渴(16~20分)占26.0%、重度口渴(21~25分)占9.5%,口渴组(透析口渴评分量表评分≥16分)占35.5%;简明口干评分量表平均(12.46±2.51)分,静息非刺激性唾液流率为0.21(0.09,0.35)ml/min。Logistic回归分析显示:平均超滤量(OR=1.001,95%CI:1.000~1.002,P=0.002)、简明口干评分量表评分(OR=3.186,95%CI:2.458~4.131,P<0.001)、口味咸度(OR=0.440,95%CI:0.209~0.930,P=0.031)是维持性血液透析患者口渴的主要影响因素。结论 口渴是困扰MHD患者常见的症状,受多种因素影响。医护人员应关注MHD患者口渴问题,结合患者特点制定针对性干预策略。

Objective To investigate the present situation and influencing factors of the thirst sensation in maintenance hemodialysis(MHD) patients. Methods A total of 369 MHD patients in the Hemodialysis Center, Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Traditional Chinese Medical University between February to May 2022 were investigated by convenient sampling method. The general information questionnaire, simplified xerostomia inventory and dialysis thirst inventory were used. The saliva secretion volume at baseline without stimulation was measured. Results The average score of dialysis thirst inventory in the 369 MHD patients was 14.80 ± 3.19;64.5% were mild thirst(10~15 scores), 26.0% were moderate thirst(16~20 scores), and 9.5% were severe thirst(21~25 scores);thirst(dialysis thirst inventory score ≥16) was found in 35.5% of the 369 MHD patients. The average score of simplified xerostomia inventory was 12.46 ± 2.51 in the 369 MHD patients. The baseline and unstimulated saliva secretion volume was0.21(0.09, 0.35) ml/min. Logistic regression analysis showed that average ultrafiltration volume(OR=1.001,95% CI:1.000~1.002, P=0.002), score of simplified xerostomia inventory(OR=3.186, 95% CI: 2.458~4.131, P<0.001) and degree of salty taste(OR=0.440, 95% CI: 0.209~0.930, P=0.031) were the main influencing factors for thirst in MHD patients. Conclusion Thirst is a common symptom that disturbs MHD patients, and is affected by many factors. Thirst in MHD patients justifies to be concerned by the medical professionals that take care of them. Intervention of thirst based on the clinical conditions of the MHD patients is required.