维持性血液透析患者衰弱发生率及影响因素的系统评价

doi:10.3761/j.issn.1672-9234.2021.04.013

摘要/Abstract

摘要：

目的系统评价维持性血液透析（maintenance hemodialysis,MHD）患者衰弱发生率及其影响因素。方法检索PubMed、CINAHL、Embase、中国知网、维普数据库、万方数据库关于MHD患者衰弱发生率及其影响因素的研究,检索时限为建库至2019年9月。由2名研究者按照标准独立进行文献筛选、资料提取和质量评价,采用Stata 12.1和RevMan 5.3软件分别进行发生率和影响因素的Meta分析。结果共纳入9篇文献,包括5 600例研究对象。Meta分析结果显示,衰弱发生率为50%[95%CI（0.31~0.69）,P<0.001]。年龄（≥60岁）、性别、吸烟史、家庭月收入、文化程度、糖尿病、周围血管疾病、心脏疾病、脑血管疾病、高血压、抑郁、血清白蛋白、血红蛋白、营养不良、透析时长是导致MHD患者衰弱的主要影响因素。结论 MHD患者衰弱发生率高且影响因素较多,应针对衰弱发生的危险因素,早期预防MHD患者衰弱发生,开展衰弱综合护理干预措施,以提高患者生活质量。

关键词: 血液透析滤过, 衰弱, 影响因素, 系统评价

Abstract:

Objective To understand frailty prevalence and its influencing factors in patients with Maintenance Hemodialysis（MHD）. Methods PubMed,CINAHL,Embase,CNKI,VIP and Wanfang Database were searched from inception to September 2019,aiming to collect studies on the prevalence of frailty and its risk factors in patients with MHD. After two researchers independently conducted literature screening,data extraction and quality evaluation was conducted according to the standards. Using Stata 12.1 and RevMan 5.3 software to carry out the meta-analysis of incidence and influencing factors respectively. Results A total of 9 articles（including 5 600 patients） were eligible for inclu-sion in the review. Meta-analysis revealed that the prevalence of frailty was 50%[95%CI（0.31~0.69）,P<0.001]. Age（over 60 years old）,gender,smoking history,family monthly income,education level,combined with diabetes,peripheral vascular disease,heart disease,cardiovascular disease,hypertension,depression,serum albumin,malnutrition and hemoglobin dialysis time were the main factors leading to the frailty of patients with MHD. Conclusion The prevalence of frailty in patients with MHD is high and there are many influencing factors. Therefore,it is necessary to prevent frailty in patients with MHD in early clinical stage and carry out comprehensive nursing intervention measures for frailty according to the risk factors of frailty,and improve patients’ quality of life.

Key words: Hemodiafiltration, Frailty, Influence factor, Systematic review

吴淑琳,宋洁,肖萍,张小满,姜倩倩. 维持性血液透析患者衰弱发生率及影响因素的系统评价[J]. 中华护理教育, 2021, 18(4): 352-357.

WU Shu-lin,SONG Jie,XIAO Ping,ZHANG Xiao-man,JIANG Qian-qian. Systematic review of frailty prevalence and its influencing factors in patients with maintenance hemodialysis[J]. Chinese Journal of Nursing Education, 2021, 18(4): 352-357.

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