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目的 探讨维持性血液透析患者的康复状况的影响康复及其相关因素.方法 对维持性血液透析治疗超过3个月以上的125例患者进行调查,在患者来透析中心进行透析时收集患者的年龄、性别、是否合并糖尿病、透析前工作状态等个人情况,记录患者当前的血红蛋白、白蛋白、尿素清除指数(Kt/V)等反映临床治疗情况的指标；并发症情况采用Charlson并发症指数进行量化；患者的活动能力用Karnofsky活动指数进行量化；心理情况根据Hamilton抑郁量表对患者进行评定；生活质量评分采用生活质量量表SF-36评分标准进行逐项评分.变量之间的相关性采用单因素相关分析.结果 125例患者中1级(生活不能自理)患者7例(5.6％),2级患者(生活仅能自理)43例(34.4％),3级患者47例(37.6％),4级患者13例(10.4％).康复状况与患者的年龄存在明显的关系,年轻的患者康复状况较年老患者好(x2=5.864,P＜0.05)；1级患者大部分为老年人、糖尿病患者,其活动指数、合并症评分和抑郁评分、生活质量评分均较差,与2～4级康复患者相比差异有统计学意义(t =5.263、7.866、6.215、5.474,P＜0.05).患者的康复状况与年龄、是否糖尿病、透析前是否工作、血白蛋白水平、活动指数、Charlson并发症指数、Hamilton抑郁积分相关(r=-0.618、-0.512、0.593、0.369、0.801、-0.696、-0.516).结论 维持性血液透析患者的康复情况受到生理、心理及其他诸多因素的影响,应加强对患者的人文关怀及情感支持.

Objective To investigate the quality of life (QOL) of hemodialysis patients and its influencing factors.Methods One hundred and twenty-five patients who underwent maintenance hemodialysis treatment for more than 3 months were selected,and their age,gender,combined disease and dialysis status were recorded.Hemoglobin,albumin and urea clearance index (Kt/V) were tested.Charlson complications index,Karnofsky activity index,Hamilton Depression Scale and MOS 36-item short health survey questionnaire were used to assess complication,activity,and psychological situation of the patients.Results Of the 125 patients,there were 7 (5.6％) grade 1 patients (could not take care of themselves),43 (34.4％) grade 2 patients (could only take care of themselves),47 (37.6％) grade 3 patients,and 13 (10.4％) grade 4 patients.A significant relationship between rehabilitation status and age was found.Young patients were better than older patients (x2 =5.864,P ＜ 0.05).The majority of grade 1 patients were older and had been diagnosed with diabetes,and their Karnofsky activity index,Charlson complications index and Hamilton Depression Scale index were lower than Grade 2-4 patients(t values were 5.263,7.866,6.215 and 5.474,respectively; all P ＜ 0.05).The QOL of the patients were related with age,diabetes,dialysis,serum albumin level,activity index,index of Charlson complications and Hamilton depression (r =-0.618,-0.512,0.593,0.369,0.801,-0.696 and-0.516,respectively).Conclusions The QOL of maintenance hemodialysis patients may be related with physical,psychological,and many other factors.It should be needed to strengthen health care and emotional support to the patients.