终末期肾脏病患者透析方式选择的影响因素.pdfVIP

· 3 6 6· 血液净化2008年7月第7卷第7 B 论 著 终末期肾脏病患者透析方式选择的影响因素 乔 婕 卢丽霞 来小彬2 李月红 赵慧萍 【摘要】目的 回顾性调查终末期肾脏病(ESRD)患者透析前透析方式的选择情况，探讨终末期肾脏 病患者透析方式选择的影响因素，为今后开展患者透析前宣传教育提供科学依据。方法 采用方便取样法， 选择规律透析治疗6～l8月的患者(包括血液透析和腹膜透析)共60例，用自设问卷回顾性调查分析北京 大学人民医院患者透析前的原发病及就诊情况、有无急诊透析及其透析原因、最终透析方式、透析方式决 定者、透析知识了解情况等。结果 ①40例(66．7％)患者曾进行过急诊透析，而未进行过急诊透析患者的 透析知识总分显著高于急诊透析组。②最终选择血液透析的患者中，急诊透析发生率显著高于最终选择腹 膜透析的患者。⑨43．3％患者参与决定最终的透析方式，36．7％患者由医生决定透析方式，20．0％患者由 家人和医生决定透析方式。本人参与决定透析方式的患者其信息获取主动性评分、透析知识总分和腹膜透 析知识评分显著高于医生决定组。结论 患者透析前对透析知识的掌握程度、患者获取信息的主动性、 及是否有过急诊透析经历是影响患者选择最终透析方式的主要因素。 【关键词】终末期。肾脏病； 透析方式选择； 透析知识 中图分类号：R459．5 文献标识码：A The influence factors to the selection of dialysis method in patients with end stage renal disease OZa0 Jie1, LA1Xiao-bin2,LULi-xia1,LIYue-hong~ZHAO H越一pingj 1DepartmentofNephrology,Peking UniversityPeoples Hospital,Beijing 100044； “rsing College,Peking University,Be(iing lO0083,Chian Correspanding au~or．LAI Xiao-bin [Abstract】0 ective For the carrying out educational program to patients with end stage renal disease (ESRD)before dialysis，we retrospectively reviewed the selection of dialysis method at the beginning of dialysis in ESRD patients，and investigated the factors relating to the selection of dialysis method in these patients．Method We recruited 60 patients who received hemodialysis(HD)or peritoneal dialysis(PD)for 6~18 months，and retro— spectively studied their primary diseases，the reason for dialysis，emergent dialysis treatment，final dec~ion of the dialysis method，the person making decision to the dialysis method，and their knowledge about his／her dialysis． Results(a)Forty of the 60 patients(66．7％)had received emergent dialysis．Patients without emergent dialysis had higher knowledge scores about dialysis than those with emergent dialysis．(b)Emergent dialysis was more fre- quently encount