摘要
目的 探讨持续非卧床腹膜透析（CAPD）患者认知功能障碍发病情况及其对依从性和生活质量的影响.方法 针对2015年10月-2016年5月在泰兴人民医院肾脏内科就诊及随访的CAPD患者进行横断面研究.使用蒙特利尔认知评估量表（MoCA）对CAPD患者认知功能进行评估;使用终末期肾脏病患者依从性自评表（ESRD-AQ）和SF-36调查表评估患者依从性及生活质量.结果 总共109名CAPD患者纳入研究,认知功能障碍（MoCA〈26分）患者占67.9%.与认知功能正常（MoCA score≥26）的CAPD患者比较,认知障碍组患者具有更高的年龄（χ^2=7.901,P=0.019）、透析龄（χ^2=7.211,P=0.025）、高血压病史（χ^2=4.254,P=0.039）、糖尿病病史（χ^2=4.331,P=0.037）,以及更低的教育程度（χ^2=7.421,P=0.024）、尿素清除率（χ^2=4.331,P=0.037）.同时,认知障碍组患者在饮食控制（χ^2=9.826,P=0.043）、液体限制（χ^2=11.056,P=0.021）、药物服用（χ^2=8.296,P=0.040）、透析方案（χ^2=10.680,P=0.030）4个方面的依从性均低于正常认知组;SF-36量表显示,认知障碍组患者在生理功能（t=2.564,P=0.013）、总体健康（t=2.262,P=0.026）、社会功能（t=2.676,P=0.018）、情感职能（t=2.644,P=0.010）、精神健康（t=2.196,P=0.031）方面得分均低于正常认知CAPD患者,差异有统计学意义.结论 CAPD患者存在较高的认知功能障碍发病率,并且对患者依从性及生活质量产生严重影响.
Objective To investigate the onset of cognitive impairments and its effects on the compliance and the quality of life of the patients with continuous ambulatory peritoneal dialysis（CAPD）. Methods A cross-sectional study was performed in the patients with CAPD who were treated and followed up in the department of Nephrology of Taixing People＇s Hospital from October 2015 to May 2016. Then the cognitive function of the patients was evaluated by the Montreal Cognitive Assessment（MoCA）.The end stage renal disease adherence questionnaire（ESRD-AQ） was applied to explore the treatment compliance of the patients. The quality of life was investigated by the SF-36 questionnaire.Results A total of 109 cases were enrolled. The proportion of cognitive impairments in the CAPD patients was 67.9% （MoCA score〈26）. Compared to the patients in the group with normal cognitive function （MoCA score≥26）,the patients with cognitive impairments were significantly older （χ^2=7.901,P=0.019）,with higher dialysis age（χ^2=7.211,P=0.025）,longer hypertension history（x2=4.254,P=0.039）,longer diabetes history （χ^2=4.331,P=0.037）,lower education degree（χ^2=7.421, P=0.024） and lower urea clearance index （χ^2=4.331,P=0.037）.At the same time,the compliance levels of the patients with cognitive impairments was significantly lower compared to the patients with normal cognitive function in the components of diet control（χ^2=9.826,P=0.043）,fluid restriction （χ^2=11.056,P=0.021）, medication therapeutic regimens（χ^2=8.296,P=0.040） and dialysis regimens（χ^2=10.680,P=0.030）. The patients with cognitive impairments also showed a significantly lower score in the dimensions of physical function （t=2.564,P=0.013）,general health（t=2.262,P=0.026）,social function （t=2.676,P=0.018）,affection function （t=2.644,P=0.010） and mental health（t=2.196,P=0.031）.Conclusions The morbidity of cognitive impairments in the CAPD patients is higher,which has a serious impact on the complia
出处
《中华现代护理杂志》
2017年第6期761-765,共5页
Chinese Journal of Modern Nursing
基金
国家自然科学基金青年科学基金项目（81600549）
关键词
腹膜透析
持续不卧床
药物治疗依从性
生活质量
认知功能障碍
Peritoneal dialysis, continuous ambulatory
Compliance of drug treatment
Quality of life
Cognitive impairments
