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目的探讨早期递增式腹膜透析对终末期肾病患者生存质量的影响。方法纳入80例终末期肾脏病患者,分为3组:递增组(n=23),初始透析剂量4 000 ml/d;标准组(n=26),透析剂量8 000 ml/d;对照组(n=31):继续接受常规药物治疗。随访12个月,评估生存质量。结果 3组间基线资料差异无统计学意义(P>0.05)。在Kt/V方面,观察期内标准组与递增组均达标(Kt/V>1.7),标准组高于递增组(P≤0.05)。在生理机能、生理职能、躯体疼痛、一般健康状况、精力、焦虑方面,观察期内标准组和递增组之间差异无统计学意义(P>0.05),从6月起,标准组和递增组比对照组有所改善(P≤0.05)。在情感职能、精神健康、抑郁方面,从6月起,标准组比递增组和对照组有所恶化(P≤0.05)。结论早期腹膜透析可以改善终末期肾病患者的生理健康。早期递增式腹膜透析不恶化终末期肾病患者的心理健康。若Kt/V>1.7,再提高Kt/V并不能进一步改善患者的生存质量。
Objective To investigate the effect of early incremental peritoneal dialysis on the quality of life in patients with end-stage renal disease. Methods Eighty patients with end-stage renal disease were included and divided into three groups: increasing group (n = 23), initial dialysis dose of 4 000 ml / d, standard group (n = 26) and dialysis dose of 8 000 ml / (n = 31): Continue to receive regular medical treatment. Follow-up of 12 months to assess the quality of life. Results There was no significant difference in baseline data among the three groups (P> 0.05). In Kt / V, the standard group and the ascending group reached the standard (Kt / V> 1.7) during the observation period, while the standard group was higher than the increasing group (P≤0.05). There was no significant difference between the standard group and the ascending group in physiological function, physiological function, physical pain, general health status, energy and anxiety during the observation period (P> 0.05). From June, the standard group and the ascending group Compared with the control group improved (P≤0.05). In terms of emotional function, mental health and depression, the standard group was worse than the incremental group and the control group from June onwards (P≤0.05). Conclusion Early peritoneal dialysis can improve the physiological health of patients with end-stage renal disease. Early incremental peritoneal dialysis does not worsen the mental health of patients with end-stage renal disease. If Kt / V> 1.7, then increase Kt / V and can not further improve the quality of life of patients.