亲属肾移植供者生活质量及影响因素调查

目的探讨亲属肾移植供者生活质量及相关影响因素,以选择对应的康复指导和护理措施．促使其生活方式改进,提高生活质量。方法采用生活质量量表（SF-36）评估亲属肾移植供者（供肾组）58人及健康人群（对照组）58人的生活质量,并对影响亲属肾移植供者生活质量的因素进行分析。结果亲属肾移植供者疼痛得分低于健康人群,总体健康状况得分高于健康人群（均P〈0．05）;其他各维度评分及生活质量总分与健康人群比较,差异无统计学意义（均P〉0．05）。文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素（P〈0．05,P〈0．01）。结论经过严格筛选的亲属肾移植供者生活质量与正常人相似;文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素。加强供肾后健康教育,提供有效的医疗社会保障,可改善供肾者的生活质量。     

亲属肾移植供者生活质量及影响因素调查

目的探讨亲属肾移植供者生活质量及相关影响因素,以选择对应的康复指导和护理措施,促使其生活方式改进,提高生活质量。方法采用生活质量量表(SF-36)评估亲属肾移植供者(供肾组)58人及健康人群(对照组)58人的生活质量,并对影响亲属肾移植供者生活质量的因素进行分析。结果亲属肾移植供者疼痛得分低于健康人群,总体健康状况得分高于健康人群(均P0.05);其他各维度评分及生活质量总分与健康人群比较,差异无统计学意义(均P0.05)。文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素(P0.05,P0.01)。结论经过严格筛选的亲属肾移植供者生活质量与正常人相似;文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素。加强供肾后健康教育,提供有效的医疗社会保障,可改善供肾者的生活质量。     

117例亲属肾移植供者术后生活质量调查及多因素分析

目的 探讨亲属肾移植供者术后生活质量及相关影响因素,为提高供者术后生命质量提供参考依据.方法 运用横断面调查研究方法以统一印制的调查表对本中心2006-2008年所实施的1 17例亲属肾移植供者术后实施问卷调查,并以同期健康人群作为对照组.调查内容包括社会人口学特征、手术并发症、经济状况、对亲属活体肾移植知晓状况、家庭支持情况、医疗保障及社会福利、术后日常锻炼等,以中文版SF-36量表测定生活质量.以t检验、方差分析和逐步回归对每一种影响因素进行分析.结果 亲属肾移植供者心理健康高于健康人群(P＜0.05);生活质量总分及其他各维度评分与健康人群比较,差异无统计学意义(P均＞0.05).单因素分析时,年龄、文化程度、经济状况、体育锻炼等4种因素与生活质量的多个领域均有关系.进一步多因素分析,在排除了各因素之间的相互影响后,对供者术后生活质量的主要影响因素分别是文化程度、经济状况、体育锻炼(P＜0.05).结论 术前应从社会心理等多角度对供者进行严格筛选,良好的社会心理背景、必要的心理指导及术后定期随访是保障供者术后良好生活质量的关键.     

影响肾移植病人服药依从性的相关因素调查分析

为探讨肾移植病人服药依从性的相关因素,并提出相应护理对策.对“肾友会“中108例肾移植术后会员进行问卷调查.结果不同年龄、文化程度及经济收入病人服药依从性比较,差异有显著性意义(均P＜0.05).提出肾移植术后治疗过程中,医护人员应加强相关知识的健康教育,根据病人的经济条件,合理选择用药,同时协助建立社会支持系统,以提高肾移植病人服药依从性.     

肾移植病人家庭护理干预效果分析

目的：了解家庭护理干预对社区肾移植病人生活质量的影响。方法：将200例出院后肾移植病人随机分为两组，干预组（100例）进行生理，心理，社会行为等护理干预，对照组（100例）未实施干预，运用日常生活能力量表（ADL），社会功能评定量表（SDSS），抑郁自评量表（SDS）及护理依赖性评估干预前后的效果进行分析，比较；同时比较两组并发症发生情况。结果：干预组病人的心理功能，社会功能及日常生活能力较干预前显著改善，差异有极显著性意义（均P＜0．01），两组并发症发生率比较，差异有极显著性意义（P＜0．01），结论：家庭护理干预可提高肾移植病人的生活质量，减少术后并发症的发生率。     

病人参与护理措施在脊柱外科病房的应用

目的:探讨病人参与护理措施对骨科病人康复的影响.方法:对112例脊柱外科患者实施参与健康决策及力所能及的自理,并观察病人的配合程度及恢复情况.结果:参与护理措施的病人,对疾病知识的了解,用药知识及功能锻炼,并发症的预防有明显提高.结论:病人参与护理措施可以增进护患沟通,提高护理治疗效果的目的.     

喉癌术后病人生活质量及干预措施

目的通过对喉癌病人行喉切除术后,提供及时有效的护理干预措施,对提高其生活质量有重要意义。方法对20例喉癌术后病人进行术前心理干预及术后的康复干预。结果20例病人术后恢复效果满意。结论术前做好病人的心理护理,术后给予有效的干预措施对改善患者的生活自理能力,提高生活质量起着重要作用。     

回访式护理指导对亲属肾移植供体人群的保护作用

目的关注亲属肾移植供体的健康,探讨回访式护理指导对此类人群的作用。方法将89例亲属肾移植供者按照其意愿分为参与组50例和对照组39例,两组均给予术后重点教育;参与组在此基础上接受回访式护理指导,即通过电话、电子邮件等方式与供者保持长期联系,持续教育。2年后,复查相关生化指标并调查其相关的生活行为,比较肾功能损害因素阳性个体发生率。结果参与组肾功能损害因素阳性个体发生率显著低于对照组(P0.05)。结论回访式护理指导通过正确引导亲属肾移植供体的生活行为方式,有益于肾移植供者的预后和长期自我健康保护。     

肾移植术后近期并发痛风原因分析与防护

本文统计６３４例肾移植术后２年内发生痛风３４例，术后均使用大量速尿及环孢素Ａ。作者结合文献，阐述了环孢素Ａ、大剂量利尿剂、移植肾排斥反应等因素对肾移植术后并发痛风的影响，同时结合临床实践，提出了相应的预防及护理措施，强调消除诱发因素、碱化尿液、减少环孢素Ａ用量及正确应用速尿、肾功能临测、对症处理以及药物治疗的管理等在肾移植术后并发痛风患者防护中的重要意义。     

颅脑外伤术后医院感染的危害因素及患者康复期生活质量调查研究

目的：探讨颅脑外伤患者术后医院感染的危害因素及康复期生活质量，针对危害因素提出护理对策，为提高患者康复期生活质量提供科学依据。方法选择2010年6月至2013年6月本院收治的颅脑外伤术后医院感染的72例患者为研究对象，探讨其发生医院感染的危害因素，并对其康复期的生活质量进行调查研究，与随机抽取的72例正常人群进行对比。结果1030例颅脑外伤患者术后发生医院感染72例，感染发生率为6.99%；危害因素为年龄、住院时间、存在意识障碍、侵袭性操作、手术时间、预防性应用抗生素、受伤类型、气管切开、手术时机；对照组生活质量评分显著高于研究组，两组差异有统计学意义（P＜ 0.05）。结论针对颅脑外伤患者术后医院感染的危害因素采取护理对策，加强对患者康复期的健康指导，并重视对并发症的护理，可有效提高患者康复期的生活质量。     

Kidney transplantation improve semen quality in patients with dialysis: A systematic review and meta-analysis

Kidney transplantation has been considered as the most effective therapy for patients with end-stage renal disease. However, less attention was attached to infertility. The present meta-analysis was conducted to compare the semen quality between patients with dialysis and patients after kidney transplantation. An extensive search in MEDLINE, PubMed and Web of Science was conducted from inception to March 2021. The data extracted for meta-analysis included sample size and characteristics, main reported outcomes like semen quality and hormone levels. For the semen quality and hormone levels, the standardized mean difference (SMD) and 95% confidential interval (CI) were calculated to evaluate the effect size. Finally, 5 studies were included in meta-analysis. Kidney transplantation could improve the sperm density of patients undergoing dialysis (SMD 1.58 [0.02, 3.15]). Additionally, the sperm motility was also improved after the kidney transplantation (SMD 3.26 [0.73, 5.79]). The sperm density of kidney transplantation patients was lower than that in healthy subjects (SMD −0.75 [−1.42, −0.07]), same as the sperm motility (SMD −0.50 [−0.80, −0.20]). Our meta-analysis suggests kidney transplantation could improve semen quality of patients with ESRD, including sperm density and sperm motility. Of note, semen quality of renal transplantation recipient still is inferior to healthy subjects.     

肾移植患者社会支持与生活质量的相关性研究

采用社会支持自评量表（ＰＲＱ－８５）第二部分和肾移植患者生活质量指数自评量表，以随机抽样法对接受明移植３个月以上来门诊复查的患者进行问卷调查。结果：肾移植患者的社会支持与我高，二者之间有非常显著的正性关系（Ｐ〈０．００１）。提示：患者的生活质量在很大程度上取决于社会支持的程度，医务人员在工作中要特别重视其社会属性，尽可能调动社会支持系统从各个维度对患者起作用，以提高其生活质量。     

Frequency and nocturia after successful renal transplantation: a normal situation?

OBJECTIVE: To analyse lower urinary tract function before and after successful renal transplantation and compare the data with those from a healthy control group. PATIENTS AND METHODS: Data were gathered by retrospective analysis of 331 charts of patients transplanted between March 1998 and May 2003, using written questionnaires and personal interview, and investigation of 150 patients. The control group consisted of 150 urologically healthy volunteers. RESULTS: Frequency and nocturia were the main lower urinary tract symptoms. Frequency of more than six voids/day was reported by 87% and nocturia of more then one void/night by 93% of all patients after successful renal transplantation. There was no significant correlation with fluid intake, diuretic medication, gender or age. Over the years the number of voids tended to decrease but remained higher than in the control group. However, 94% of all patients were happy with the quality of life after renal transplantation. CONCLUSION: Frequency and nocturia are the two main characteristics of lower urinary tract function after renal transplantation, probably through a combination of high fluid intake, a long-term defunctionalized urinary bladder during renal replacement therapy, a denervated donor kidney, concomitant diseases and psychosocial distress. Quality of and satisfaction with life were not compromised.     

用健康调查量表评价肝移植受者生命质量的研究

目的 调查和了解肝移植受者术前和术后的生命质量状况.方法 在施行肝移植手术的受者中随机抽取102例(术前30例、术后72例)进行问卷调查.健康调查(SF-36)量表共有36个条目,覆盖生命质量的8个维度,分别命名为:生理功能、生理职能、躯体疼痛、总体健康白评、活力、社会功能、情感职能和精神健康.所有的维度选项得分经线性转换为0～100分.分析和比较受者肝移植术后与术前生命质量的差别;对影响生命质量的因素进行分析.结果 肝移植术后受者的各个维度得分为(44.51±38.22)～(86.74±11.66)分.远远高于术前受者.原发病、术前终末期肝病模型(MEID)评分、术后并发症对生命质量的某些维度有影响.而性别、年龄及原发病复发等因素对生命质量影响不大.结论 肝移植受者术后生命质量较术前明显提高,SF-36量表可用于肝移植受者术后生命质量的评估和研究.     

儿童肾移植受者术后生存质量和心理状况现状及影响因素分析

目的  探讨儿童肾移植受者术后生存质量和心理状况现状并分析其影响因素。 方法  选取96例儿童肾移植受者为研究对象,收集受者的一般资料,采用儿童生存质量量表（PedsQL^TM3.0）评估其生存质量,采用长处和困难问卷（SDQ）评估其心理状况,对儿童肾移植受者术后生存质量和心理状况的影响因素进行单因素和多因素分析。 结果  儿童肾移植受者术后生存质量总分为（71±14）分,困难总分为（12.4±5.8）分。单因素分析结果显示,性别、术后体质量指数（BMI）和肾移植术后并发症是儿童肾移植受者术后生存质量总分的影响因素（均为P < 0.05）;性别、肾移植术后并发症和肾移植术后随访时间是儿童肾移植受者困难总分的影响因素（均为P < 0.05）。多因素分析结果显示,性别、术后BMI、肾移植术后并发症、肾移植前透析种类是儿童肾移植受者术后生存质量的影响因素,性别、肾移植术后并发症、肾移植术后随访时间是儿童移植受者术后心理状况的影响因素（均为P < 0.05）。 结论  儿童肾移植受者术后生存质量和心理状况较好,临床中应重点关注女性、术后BMI偏低、肾移植术后出现并发症及肾移植术后随访时间较短的患儿,预防性给予干预措施,进一步提高生存质量。     

Measuring Patients’ Level of Knowledge Regarding Kidney Transplantation in Eastern Hungary

Adequate knowledge is needed to make the correct decision regarding kidney transplantation. The purpose of this study was to measure the demographic, sociologic, economic, and cultural factors that may influence patients’ decision-making regarding kidney transplantation and to explore patients’ knowledge of renal replacement therapies. A total of 254 end-stage renal disease patients (predialysis, peritoneal dialysis, and hemodialysis) from 8 dialysis centers in eastern Hungary participated in our study. We developed a questionnaire that measures patients’ knowledge of renal replacement therapies and the role of sociodemographic, economic, and cultural factors that may influence their knowledge. Factors influencing the knowledge scores were evaluated using a multivariate linear regression adjusted for 8 factors. We found a significant correlation between education level and knowledge score, where patients with greater education (greater than high school: β = 3.003; P < .001; high school: β = 1.906; P < .001) achieved higher knowledge scores than those without. Moreover, patients with a previous kidney transplant (β = ?2.111; P < .001) had greater knowledge in the field. Our study identified a risk group where targeted, personalized patient education is essential.     

Couples After Renal Transplantation: Impact of Sex and Relationship Quality on Adherence in a Prospective Study

BackgroundIn patients after kidney transplantation, nonadherence to immunosuppressant medication is a common problem. Identifying factors that influence adherence could optimize medical care and prevent nonadherence. Kidney transplantation is a stressful situation for the patient and also for the relatives. The recipients of renal transplants as well as the family system have to be taken into account as potential impact factors.MethodsFifty-six couples with a renal transplant recipient were investigated regarding adherence, relationship satisfaction, social support, and quality of life. Moreover, sex and role differences (patient vs partner) as well as differences within the couple were analyzed. Impact factors on adherence were identified.ResultsFemale recipients of renal transplant reported higher relationship satisfaction than male recipients, female spouses, and male spouses. Physical quality of life was lower in renal transplant recipients compared with caregivers. For male renal transplant recipients, significant predictors of adherence, such as social support, relationship quality, and quality of life emerged, whereas for female renal transplant recipients mental quality of life and education level were found to influence adherence.ConclusionsThe study reveals the importance of relationship functioning of couples after kidney transplantation, as well as considering sex and role differences. There is a need to examine the posttransplantation nonadherence risk profile of women and men separately.     

洛阳市维持性血液透析患者生活质量调查及影响因素分析

目的 通过对洛阳市维持性血液透析(maintenance hemodialysis,MHD)患者的生活质量进行调查,分析影响MHD患者生活质量的因素,为改善MHD患者生活质量提出依据.方法 采用质量调查问卷(Short-Form 36 Health Survey Questionnaire,SF-36)生活质量量表对洛阳市第一人民医院、洛阳市中心医院、河南科技大学第一附属医院、河南科技大学第三附属医院、解放军150医院、洛阳市第一中医院、洛阳市第二中医院352例MHD患者进行问卷调查,计算血液透析患者生活质量得分,与健康常模进行比较,分析影响MHD患者生活质量的因素.结果 研究组患者SF-36量表8个维度的得分显著低于健康常模(P＜0.05).MHD患者生活质量与性别、年龄、透析龄、血红蛋白、透析充分性(Kt/V)等因素有关.结论 MHD患者生活质量明显低于健康人群,年龄、性别、透析龄、血红蛋白、Kt/V是影响MHD患者生活质量的重要因素,改善这些因素有望提高MHD患者的生活质量.     

Heart rate variability during chronic hemodialysis and after renal transplantation: studies in patients without and with systemic amyloidosis.

The present study was undertaken to compare heart rate variability (HRV) values in patients on maintenance hemodialysis with no evidence of ischemic or hypertensive heart diseases to those of age- and gender-matched healthy individuals and those of patients after renal transplantation. To assess the effects of a common confounding factor, HRV values were also determined in patients with systemic amyloidosis, in chronic hemodialysis, and after successful renal transplantation. Spectral analyses of RR intervals from continuous electrocardiogram recordings were performed to quantify ultra low frequency, very low frequency, low frequency, and high frequency powers. HRV determinations were all significantly reduced in uremic patients undergoing hemodialysis compared with the healthy control subjects, especially in those with systemic amyloidosis. Renal transplantation normalized HRV in most patients; HRV, however, remained reduced in isolated amyloidosis patients with cardiac or adrenal involvement. HRV circadian day/night differences were preserved in hemodialysis patients and after renal transplantation in those without amyloidosis but not in those with amyloidosis. These data suggest that reduced HRV in chronic hemodialysis patients may precede other manifestations of cardiovascular disease. In uremic patients with amyloidosis, a more severe form of autonomic failure may occur. Successful transplantation corrects HRV abnormalities in most patients, suggesting that the autonomic dysfunction of uremia is caused by humoral factors reversed by the normalization of the renal function.