老年维持性血液透析患者的疲乏及其相关因素研究

A study of fatigue and its related factors in elderly patients undergoing maintenance hemodialysis

中文关键词: 老年  维持性血液透析  疲乏  危险因素

英文关键词: elderly  maintenance hemodialysis  fatigue  risk factor

中文摘要:

      目的 调查分析老年维持性血液透析(MHD)患者疲乏状况及相关影响因素,以期为预防疲乏提供研究依据.方法 选取2020年1月-2022年8月于新疆医科大学第一附属医院诊治的150例MHD老年(年龄≥65岁)患者作为研究对象.收集这些患者的病历资料,采用Piper疲乏修订量表(PFS-R)评估其疲乏状况,并应用多因素Logistic回归分析疲乏的影响因素.结果 MHD患者PFS-R评分为(5.09±1.22)分,中重度疲乏发生率为76.67％.单因素分析显示,MHD患者疲乏状况与年龄、学历、透析龄、合并症、睡眠障碍、人均月收入、血尿素氮(BUN)、三酰甘油(TG)、血红蛋白(Hb)、血白蛋白(Alb)有关(P＜0.05);多因素Logistic回归分析显示,年龄≥75岁、透析龄≥5年、有合并症、有睡眠障碍、人均月收入＜2 000元、Hb＜110 g/L、Alb＜35 g/L是MHD患者中重度疲乏的独立危险因素(P＜0.05).结论 老年MHD患者普遍存在中度疲乏,其疲乏状况受年龄、透析历时、合并症状况、睡眠质量、经济收入水平、血红蛋白及白蛋白值等多重因素影响.因此,临床工作人员应针对这些影响因素制定个体化的干预措施,以期改善MHD患者的疲乏症状.

英文摘要:

      Objective To investigate and analyze the fatigue status and its related influencing factors in elderly patients undergoing maintenance hemodialysis(MHD)and provide research basis for fatigue prevention.Methods A total of 150 eld-erly patients(aged ≥65 years)who underwent MHD in First Affiliated Hospital of Xinjiang Medical University from January 2020 to August 2022 were selected as the study subjects.Their case data were collected.The Piper Fatigue Scale-Revised Ver-sion(PFS-R)was used to assess their fatigue status.Multivariate Logistic regression was used to analyze the influencing factors of fatigue.Results The PFS-R score of MHD patients was(5.09±1.22)points and the incidence of moderate and severe fa-tigue was 76.67％.Univariate analysis showed that fatigue status of MHD patients was related to age,education level,dialysis age,comorbidities,sleep disorders,monthly income per capita,blood urea nitrogen(BUN),triglyceride(TG),hemoglobin(Hb)and blood albumin(Alb)(P＜0.05).Multivariate Logistic regression analysis showed that age ≥75 years,dialysis age≥ 5 years,comorbidities sleep disorders,monthly income per capita＜2 000 yuan,Hb＜110 g/L and Alb＜35 g/L were in-dependent risk factors for moderate to severe fatigue in MHD patients(P＜0.05).Conclusion Moderate fatigue is common in elderly MHD patients,and their fatigue status is affected by multiple factors such as age,dialysis duration,comorbidities,sleep quality,economic income level,Hb and Alb levels.Therefore,clinical staff should develop individualized intervention measures targeting these influencing factors in order to alleviate fatigue symptoms of MHD patients.