维持性血液透析患者衰弱发生情况及其与心理状况的关系

The Incidence of Frailty in Maintenance He-modialysis Patients and Its Relationship with Psychological Conditions

摘要: 目的：调查维持性血液透析患者的衰弱和心理状况的现状，探讨患者衰弱与心理状况的关系。方法：采取方便抽样法，选取西安交通大学第一附属医院303例维持性血液透析患者作为研究对象。选用一般资料调查表，FRAIL衰弱量表，医院焦虑和抑郁量表(HADS)进行横断面调查。结果：303例维持性血液透析患者中，非衰弱组82例(27.1%)、衰弱前期组184例(60.7%)、衰弱组37例(12.2%)。三组患者在年龄、受教育程度、握力、合并糖尿病、焦虑和抑郁的差异均具有统计学意义(P < 0.05)；Pearson相关性分析显示衰弱评分与年龄、焦虑、抑郁呈正相关，与握力值呈负相关(P < 0.05)；Logistic回归分析显示，年龄、抑郁为MHD患者衰弱的独立危险因素，握力为保护因素(P < 0.05)。结论：维持性血液透析患者衰弱发生率较高，抑郁是衰弱的危险因素。医护人员应早期对该人群进行衰弱评估，重视患者的心理健康，及时采取有效的干预措施，预防和延缓衰弱的发生。

Abstract: Objective: Investigate the current status of maintenance hemodialysis patients’ frailty and psycho-logical status, and explore the relationship between patients’ frailty and psychological status. Methods: The convenience sampling method was adopted to select 303 maintenance hemodialysis patients from the First Affiliated Hospital of Xi’an Jiaotong University as the research objects. The general information questionnaire, the FRAIL Frailty Scale, and the Hospital Anxiety and Depres-sion Scale (HADS) were used to conduct a cross-sectional survey. Results: Among the 303 mainte-nance hemodialysis patients, 82 patients (27.1%) were in the non-debilitating group, 184 patients (60.7%) were in the pre-debilitating group, and 37 patients (12.2%) were in the debilitating group. The differences between the three groups of patients in age, education level, grip strength, diabetes, anxiety and depression were statistically significant (P < 0.05); Pearson correlation analysis showed that the frailty score was positively correlated with age, anxiety, and depression, and was correlated with the value of grip strength It was negatively correlated (P < 0.05); Logistic regression analysis showed that age and depression were independent risk factors for weakness in MHD patients, and grip strength was a protective factor (P < 0.05). Conclusion: Maintenance hemodialysis patients have a higher incidence of frailty, and depression is a risk factor for frailty. Medical staff should conduct an early frailty assessment of the population, pay attention to the patient’s mental health, and take effective intervention measures in a timely manner to prevent and delay the occurrence of frailty.