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维持性血液透析患者衰弱变化轨迹及影响因素的纵向研究

Longitudinal study on the trajectory and influencing factors of frailty in patients receiving maintenance hemodialysis
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摘要 目的探讨维持性血液透析患者衰弱变化轨迹,并分析其影响因素。方法采用便利抽样法,于2022年1—10月选取湖北民族大学附属民大医院血液净化中心收治的维持性血液透析患者为研究对象。采用临床衰弱量表于患者首次透析及透析1、3、6、12个月进行调查。采用潜类别增长模型识别衰弱变化轨迹的潜在类别,并对潜在类别进行影响因素分析。结果共发放问卷255份,回收有效问卷212份,问卷有效回收率为83.14%。维持性血液透析患者衰弱变化分为中度衰弱加重组(n=64)、衰弱改善组(n=110)和亚衰弱平稳组(n=38);各类别的维持性血液透析患者归属于各个潜在类别的平均概率分别为0.948、0.938、0.950;年龄、性别、体重指数、贫血、患病后继续工作、合并基础疾病是维持性血液透析患者衰弱变化轨迹的影响因素(均P<0.05)。结论维持性血液透析患者从首次透析至规律透析12个月的衰弱变化存在3种轨迹类型,可依据影响因素实施针对性干预措施。 Objective To explore the trajectory of frailty changes in patients receiving maintenance hemodialysis and analyze its influencing factors.Methods Maintenance hemodialysis patients at the Blood Purification Center of the Minda Hospital of Hubei Minzu University from January to October 2022 were selected by convenience sampling.The Clinical Frailty Scale(CFS)was used to survey patients at the start of dialysis and one,three,six,and 12 months of dialysis.Latent class growth modeling was employed to identify the potential classes of frailty trajectory changes and analyze the influencing factors of these classes.Results A total of 255 questionnaires were distributed,with 212 valid responses,yielding an effective response rate of 83.14%.The changes in frailty among the patients receiving maintenance hemodialysis were categorized into three groups:moderate frailty worsening group(n=64),frailty improvement group(n=110),and stable pre-frailty group(n=38).The average probabilities of patients belonging to each latent class were 0.948,0.938,and 0.950,respectively.Age,gender,body mass index,anemia,continuing to work after illness onset,and comorbidities were identified as influencing factors of frailty trajectory changes in these patients(all P<0.05).Conclusions There are three types of frailty trajectory changes in patients receiving maintenance hemodialysis from the start of dialysis to 12 months of regular dialysis.Targeted interventions can be implemented based on the identified influencing factors.
作者 赵传静 王旺珍 刘虹 王高月 于金英 黄升飞 Zhao Chuanjing;Wang Wangzhen;Liu Hong;Wang Gaoyue;Yu Jinying;Huang Shengfei(Blood Purification Center,Minda Hospital of Hubei Minzu University,Enshi 445000,China;Department of Radiology,The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)
出处 《中华现代护理杂志》 2024年第24期3237-3242,共6页 Chinese Journal of Modern Nursing
关键词 血液透析 衰弱 轨迹 纵向研究 影响因素 Hemodialysis Frailty Trajectory Longitudinal study Influencing factor
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