血液净化3月后患者自主选择透析模式可行性的单中心调查

    Feasibility assessment on the independent selection of dialysis methods in ESRD patient after 3-month blood purification:A blood purification center observation study in the Xinjiang Uyghur Autonomous Region

    • 摘要: 目的 调查经透析治疗3个月以上的终末期肾脏病(end stage renal disease,ESRD)患者对透析知识及优缺点的掌握情况,分析其重新选择透析模式的意愿及可行性。方法 采用方便取样法,于2016年1月至2017年12月间,选择开始准备在新疆维吾尔自治区人民医院进行规律透析治疗的146例ESRD患者,包括85名血液透析(hemodialysis,HD)患者、61名腹膜透析(peritoneal dialysis,PD)患者,通过问卷调查形式了解患者人口统计学资料、两种透析模式选择的影响因素及透析过程中尿量减少情况,统计分析患者重新选择长期透析模式的意愿和可行性。结果 HD组患者绝大多数由医师介绍进入该透析模式(92.94%),PD组自主选择进入该透析模式的患者比例(55.74%)占多数,两组比较差异有统计学意义(P<0.05)。透析治疗3个月后,70%以上的PD患者了解了两种透析模式的知识及优缺点,但HD组90.59%患者仍不了解PD知识,两组比较差异有统计学意义(P<0.05)。HD组患者急诊透析经历多于PD组(P<0.05)。两组患者透析前24 h尿量无差异,透析3个月后,HD组尿量减少患者的比例高于PD组(P<0.05)。经过3个月治疗和宣教后,HD和PD组分别有41.18%和19.67%患者愿意调整透析模式。结论 透析模式知识不足是影响患者自主选择透析模式的主要因素,急诊透析经历在一定程度上也影响患者对透析模式的选择。透析治疗3个月后,ESRD患者对透析知识和其优缺点掌握情况明显改善,并对两种透析模式对残余尿量影响有切身体验,基本具有理性自主选择的能力,可以根据自身情况重新选择透析模式。

       

      Abstract: Objective To investigate mastering of the patients with SRD(ESRD)with dialysis treatment of over 3 months about knowledge and advantages or shortcomings of the two dialysis therapies in our dialysis center, and evaluate the intention and feasibility of their independent selection of dialysis methods.Methods With convenient sampling,146 patients with ESRD,who started to conduct regular peritoneal dialysis in People’s Hospital of Xinjiang Uyghur Autonomous Region between January 2016 to December 2017,were selected and divided into the hemodialysis group(HD group,85 patients)and the peritoneal dialysis group(PD group,61 patients)according to their dialysis methods.A retrospect survey questionnaire was made to learn about demographic data,influencing factors of selection of the two dialysis modes and urine decrease during dialysis,and to analyze the intention and feasibility of the patients’ new selection of long-term dialysis.Results The HD patients most selected this dialysis mode(92.94%)mainly according to their physician’s introduction before dialysis,while the PD patients who independently selected PD had a big proportion(55.74%).There was statistically significant difference between the two groups(P<0.05).After three months of dialysis,over 70% of the patients learned about the knowledge and features of the two dialysis modes,but 90.59% patients in the HD group did not yet master the PD knowledge,with statistically significant difference between the two groups(P<0.05).The emergent dialysis records in the HD group were more than those in the PD group(P<0.05).24-hour urine volume before dialysis had no difference between the two groups,after 3 months of treatment the proportion of patients with decrease urine volume in the HD group was higher than that in the PD group(P<0.05).With 3 months of treatment and education,there were 41.18 and 19.67% patients in the HD and PD groups,respectively,who were willing to adjust their dialysis method.Conclusions Lack of sufficient knowledge about dialysis is the main factor affecting ESRD patient`s independent selection of dialysis methods.besides that,more experience of emergent dialysis also plays a vital role in their selection.Both 3-month experience of dialysis and the changes of urine volume in the course of different dialysis therapies contribute to accumulation of the knowledge and the practice of two dialysis methods.This makes it possible for ESRD patients to have the ability to select dialysis mode independently,and make them select suitable dialysis method based on their own specific conditions.

       

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