腹膜透析对慢性肾衰竭患者心理及生活质量的影响

目的探讨腹膜透析对慢性肾衰竭患者心理状态及生活质量的影响。方法 159例慢性肾衰竭腹膜透析患者,据透析龄分成四组：A组（透析龄≤3个月）49例;B组（3个月〈透析龄≤12个月）38例;C组（12个月〈透析龄≤24个月）35例;D组（透析龄〉24个月）37例。所有入选患者均采用汉密尔顿焦虑、抑郁量表、SF-36生活质量问卷评估其焦虑、抑郁状态及生活质量,并进行统计学分析。结果 159例慢性肾衰竭腹膜透析患者,抑郁、焦虑的总发生率分别为17%、27.1%;A组患者的抑郁发生率明显高于B、D组,焦虑发生率明显高于B、C组（P〈0.05）,D组患者的焦虑发生率明显高于B组（P〈0.05）。焦虑、抑郁与透析龄呈负相关（r=-0.193,P=0.015;r=-0.235,P=0.003）,焦虑与抑郁呈正相关（r=0.75,P=0.000）;A组患者的生活质量评分在多个维度均明显低于其他三组（P〈0.05）;患者体力状况、体力作用、疼痛、情感与精神状态、情感作用、社会功能、精力状况此7个维度的评分与透析龄均呈正相关（P〈0.05）。结论腹膜透析患者抑郁、焦虑发病率高,普遍存在生活质量差。但随着腹膜透析患者透析龄增加,抑郁、焦虑的发生率降低,生活质量有所提高。医护人员应根据患者的透析龄进行相应的心理辅导和治疗,减少患者抑郁、焦虑的发生,以提高患者的生活质量。

The effect of peritoneal dialysis on psychological state and life quality in patients with chronic renal failure

Objective To compare the peritoneal dialysis（PD） patients psychological state and quality of life in different dialysis period.Methods 159 PD patients were divided into 4 groups by dialysis duration：Group A（PD duration ≤3 months,n=49）,Group B（3 months﹤PD duration ≤12 months,n=38）,Group C（12 months﹤PD duration ≤24 months,n=35）;Group D（24months﹤PD duration,n=37）.Quality of life was evaluated by the 36-item short Form health survey questionnaire（SF-36）.Hamilton depression scale（HAMD） and Hamilton anxiety scale（HAMA） were used to access patients psychological state.Results Depression incidence in group A was higher than group B and group D（P0.05）,anxiety incidence in group A was higher than group B and group C（P0.05） anxiety incidence in group B was lower than group D（P0.05）.The incidence of anxiety and depression were negatively correlated with PD duration（r=-0.193,P=0.015 Vs r=-0.235,P=0.003）;While anxiety＇ incidence was positively correlated with depression（r =0.75,P=0.000）.According to SF-36,patients in group A had significantly lower scores in multiaspect than other groups（P0.05）.The scores of physical function,role limitations caused by physical health problems,bodily pain,emotional well-being,role limitations caused by emotional Problems,social function,energy/fatigue were positively correlated with PD duration（P0.05）.Conclusion Peritoneal dialysis patients with high rates of depression and anxiety,and the life quality is poor.But as the patients dialysis duration increases,the incidence of depression and anxiety reduce,life quality improved.Medical personnel should according to patients＇ dialysis duration for the corresponding psychological counseling and treatment in patients with depression,anxiety,reduce the occurrence of PD patients,improve the quality of life of the patients.