维持性腹膜透析患者便秘情况调查及其影响因素分析

摘要

目的 通过横断面研究,调查腹膜透析(peritoneal dialysis,PD)患者便秘的发生情况,分析其相关危险因素,以指导PD患者便秘相关的预防治疗和教育,减少便秘所致PD相关并发症的发生.方法 采用国际统一的罗马Ⅲ便秘诊断标准对北京大学人民医院腹膜透析中心2015年6～12月规律随访的PD患者进行便秘问卷调查及相关影响因素分析.结果 ①143例PD患者入选,男性73例(51.05％),平均年龄(59.15±13.04)岁,透析龄(37.14±27.79)月.②50例患者存在便秘(35％),61例患者服用或使用缓泻剂(42.65％),应用缓泻剂的种类为(1.69±0.92)种.③Logistic回归分析显示,口服阿托伐他汀钙的剂量(OR=1.807,95％ CI:1.021～1.157,P=0.009)、Karnofsky评分(OR=1.606,95％CI:1.704～2.401,P=0.021)以及年龄(OR=1.856,95％ CI:1.088～3.168,P=0.023)是PD患者便秘的独立危险因素(P均＜0.05).结论 维持性PD患者存在普遍且较高的便秘发生率,在老年、活动能力差以及口服阿托伐他汀钙剂量大的患者更易发生.对于这些患者除日常基础的避免便秘重要性的教育,还应针对性地给予预防及规范化治疗.%Objectives To investigate the prevalence of constipation and its related risk factors in peritoneal dialysis (PD) patients through a cross-section study in order to guide the prevention,treatment and education of constipation and to reduce constipation-related complications in PD patients.Methods Stable maintenance PD patients who received regular follow-up in PD center of Peking University People's Hospital from Jun.2015 to Dec.2015 were enrolled in this study.A questionnaire survey for constipation was used.Constipation was diagnosed by using the international standard of Rome Ⅲ.General information,drug usage and laboratory tests in these patients were collected.Related risk factors for constipation were analyzed by logistic regression analysis.Results ①A total of 143 PD patients (73 males;average age 59.15± 13.03 years) were enrolled in this study.Their PD duration was 37.14±27.79 months.② Among the 143 patients,50 patients (35％) had constipation and 61 patients (42.65％) took or used 1.69±0.92 types of laxatives.③ Logistic regression analyses showed that oral dose of atorvastatin (OR=1.807,95％ CI:1.021 ～ 1.157,P=0.009),Kamofsky score (OR=1.606,95％ CI:1.704～2.401,P=0.021) and age (OR=1.856,95％ CI:1.088～3.168,P=0.023) were independent risk factors for constipation in PD patients.Conclusions The prevalence of constipation in maintenance PD patients was high.Constipation was more likely to occur in patients who were elderly,had less activity,and took higher dose of atorvastatin.In addition to conventional education about the importance of constipation prevention,specific preventive and standardized treatment for constipation should be given for PD patients.