腹膜透析病人随访依从性及生存状况研究

目的:了解腹膜透析病人随访依从性和生存状况,探讨腹膜透析病人随访依从性对生存的影响。方法:采用回顾性队列研究方法,通过查阅门诊随访病历收集2006年2月至2008年2月期间病人的相关资料,用病人门诊随访率代表其随访依从性。结果:共有296例腹膜透析病人纳入该研究。门诊随访率为70%±27%(0～100%),女性、自费病人随访依从性差。随访期间,有46例因死亡(38例)、转入血液透析(3例)或肾移植(5例)而退出腹膜透析治疗。多因素Cox回归分析显示门诊随访率是腹膜透析病人生存的独立影响因素(OR=0.179,P=0.003,95%CI=0.057～0.568)。结论:随访有利于腹膜透析病人的生存,应鼓励病人坚持随访,以提高腹膜透析病人的生存率。

Follow-up compliance and outcomes among peritoneal dialysis patients

Objective：To describe the follow-up compliance and outcomes among peritoneal dialysis （PD） patients, and analysis the relationship between follow-up compliance and outcomes. Methods： A prospective cohort study begun from Feb. 2006 to Feb. 2008 and data were obtained from clinic records. The frequency of follow-up was used as the indicator of follow-up compliance. Results： Totally 296 PD patient were enrolled in this study, whose frequency of follow-up was 77% 5： 27% （0-100%）. Gender and medical care assurance were the determinants of follow-up compliance. During the follow-up, 38 pa- tients died, 5 patients underwent transplantation and 3 patients transferred to hemodialysis. Analyses with multivariate Cox models, which took other confounding variables as covariates, indicated the independent associations between a higher frequency of follow-up compliance and a lower risk of death （OR=0.179, P=0.003, 95%CI=0.057-0.568）. Conclusion： Follow- up compliance is beneficial to the survival of PD patients. Nurses should encourage PD patients to adhere to follow-up in order to improve their outcomes.