长程血液透析对维持性血液透析患者生活质量的影响

目的 研究长程血液透析(LSHD)对维持性血液透析(MHD)患者生活质量的影响.方法 选取首都医科大学附属北京友谊医院血液净化中心40例MHD患者,通过问卷调查和收集临床资料相结合的方法,进行前瞻性配对临床研究.根据临床资料、检验指标、睡眠质量将患者配对分组为普通透析(HD)组和LSHD组,各20例,进行6个月的临床试验,观察两组患者临床表现、生化指标及生活质量的情况.结果 LSHD组的Kt/V(1.73±0.36比1.41±0.23,P＜0.05)、血红蛋白[(124.67±9.08)比(110.55±9.01) g/L,P＜0.01]、血清白蛋白[(45.01±2.66)比(39.28±2.63) g/L,P＜0.01]显著高于HD组 ;血压控制比例(14/20比5/20,P=0.010)和睡眠质量(16/20比5/20,P=0.001)显著优于HD组 ;生活质量SF-36评分显著高于HD组(P＜0.05),差异均有统计学意义.结论 长程透析可以改善MHD患者睡眠质量、营养状况,从而改善生活质量.

Effect of long session hemodialysis on the quality of life in maintenance hemodialysis patients

Objective To study the effect of long session hemodialysis (LSHD) on the quality of life in maintenance hemodialysis (MHD) patients. Methods A total of 40 MHD patients in our dialysis center were enrolled in the study. Quality of life was investigated by SF-36 table. Sleep questionnaire survey concluded the Athens insomnia scale (AIS), Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale（ESS). Clinical data were collected. Forty MHD patients were equally divided into HD and LSHD groups according to clinical data and sleep quality score for prospective study. Hemodialysis dose of HD group was 4 h thrice weekly, and of LSHD group was 8 h thrice weekly. The trial lasted for 6 months. Changes of life quality were compared between two groups. Results As compared to HD group, LSHD group had significant higher Kt/V (1.73±0.36 vs 1.41±0.23, P＜0.05), higher levels of serum hemoglobin [(124.67±9.08) vs (110.55±9.01) g/L, P<0.01] and albumin [(45.01±2.66) vs (39.28±2.63) g/L, P<0.01]. better sleep quality score(16/20 vs 5/20, P=0.001) and higher blood pressure control proportion (14/20 vs 5/20, P=0.010), higher score of SF-36(P<0.05). Conclusion LSHD can improve the life quality of MHD patients by increasing sleep quality and nutrition level.