尿毒症患者116例肾移植后生活质量的调查 |
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作者姓名: | 彭贵军 吴耀松 陈玉龙 张 翥 王光策 |
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作者单位: | 1河南中医学院第一附属医院,河南省郑州市 450000
2河南中医学院基础医学院,河南省郑州市 450005 |
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摘 要: | 背景:作为评价疗效的重要指标,关于血液透析患者生活质量及其影响因素的研究越来越多,而关于肾移植患者生活质量的研究报道还很少,尤其在国内这方面的研究更少。
目的:采用一系列调查问卷对肾移植后患者的生活质量进行评估。
方法:116例尿毒症患者,其中肾移植受者62例,等待肾移植受者54例;男性71例,女性45例。统计患者年龄、性别、婚姻状态、文化程度、经济水平和医疗费支付情况等情况。采用Beck抑郁量表、健康状况调查表、终末期肾脏疾病移植患者症状调查表以及就业信息表调查分析116例患者的生活质量。
结果与结论:肾移植受者组与等待肾移植受者组在基础疾病、性别、婚姻状态、教育程度、经济水平、医疗费支付情况等方面无明显差异。肾移植受者组抑郁水平明显低于等待肾移植受者组(P ≤ 0.01),肾移植受者组在躯体功能和躯体总分值、总体健康感知和社会功能方面明显优于等待肾移植组(P ≤ 0.001,P ≤ 0.01)。在肾移植受者组中,与术后无并发症者相比,术后产生并发症者表现为更低的社会功能水平、总体精神健康状态和躯体总价值(P ≤ 0.05)及更高水平的抑郁(P ≤ 0.05)。肾移植后超过1年的患者比肾移植后少于1年的患者表现出更差的心理适应性(P ≤ 0.05)。在肾移植受者组中,与血肌酐<150 µmol/L的患者相比,血肌酐≥ 150 µmol/L的患者表现为更严重的认知功能障碍(P ≤ 0.05)。肾移植提高了终末期肾病患者的生活质量,但肾移植前后患者的就业状态无明显的改变。除了躯体因素外,社会支持被证实对肾移植受者生活质量有着很大的积极影响。
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关 键 词: | 尿毒症 肾移植 生活质量 调查 受者 |
收稿时间: | 2010-07-25 |
Survey about quality of life in 116 uremia patients after renal transplantation |
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Authors: | Peng Gui-jun Wu Yao-song Chen Yu-long Zhang Zhu Wang Guang-ce |
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Institution: | 1First Affiliated Hospital, Henan College of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
2Basic Medical College, Henan College of Traditional Chinese Medicine, Zhengzhou 450005, Henan Province, China |
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Abstract: | BACKGROUND:More and more studied have reported quality of life and influence factors among hemodialysis patients; however, studies addressing quality of life in patients following renal transplantation were less, in particular, the reports were less aboard.
OBJECTIVE:To investigate effective methods of improving the quality of life in uremia patients following renal transplantation.
METHODS:A total of 116 uremia patients were divided into two groups: renal transplant recipients (n=62) and dialysis patients awaiting transplantation (n=54). There were 71 males and 45 females. Both groups were asked to estimate age, sex, marriage status, educational level, economic level, and medical cost by responding to a multidimensional questionnaire that sought information in the following areas: Beck Depression Inventory (BDI), Short Form 36 Health Survey Questionnaire (SF-36), End Stage Renal Disease Symptom Checklist transplantation Module (ESRD-SCL), and Information about employment.
RESULTS AND CONCLUSION:There was no significant difference in age, sex, marriage status, educational level, economic level, and medical cost between the two groups. The BDI revealed that the depression level of renal transplant recipients was significantly lower than dialysis patients awaiting transplantation (P ≤ 0.01). The SF-36 revealed significantly higher values for transplant recipients in terms of physical functioning, general health perceptions, social functioning, and physical summary value (P ≤ 0.001, P ≤ 0.01). ESRD-SCL revealed renal transplant recipients who had suffered from complications after surgery showed significantly worse levels of social functioning, general mental health, physical summary value (P ≤ 0.05) and a higher level of depression (P ≤ 0.05) compared to those without any complications related to the surgical procedure. Patients who had the transplantation procedure for more than one year showed worse general mental health than those within one year (P ≤ 0.05). Patients with a serum creatinine of more than 150 µmol/L had significantly greater limited cognitive capacity in comparison to those with less than 150 µmol/L (P ≤ 0.05). Despite higher quality of life after transplantation, the rate of vocational rehabilitation remained low. Besides physical factors, social support was demonstrated to have a profound positive influence on renal transplant recipients. |
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