Ozçürümez Gamze, Tanriverdi Nilgün, Zileli Leyla
Oğr. Gör., Başkent U. Tip Fak., Ankara.
Turk Psikiyatri Derg. 2003 Spring;14(1):72-80.
Primary treatment modalities of chronic renal failure (CRF) are dialysis and renal transplantation. According to 1997 data there were 10,000 hemodialysis and 1893 continuous ambulatory peritoneal dialysis (CAPD) patients in Turkey. On a yearly basis 360 renal transplantation procedures take place. In deciding for one of the treatment modalities, medical criteria are of partial importance. On the other hand, in terms of psychosocial adjustment and functioning and quality of life, even the expert clinicians emphasize that is very difficult to predict which treatment modality is best for the patient. While some researchers report that psychiatric morbidity and disability of CRF are high and there is no difference between the chosen treatment modalities, most of them report that transplantation is more advantageous than dialysis, and quality of life is better in transplant patients. On the other hand, some researchers claim that psychological adjustment varies during the treatment of CRF and psychiatric symptoms decrease with time. In this paper, psychiatric and social problems in CRF and the effect of these problems on quality of life are reviewed. According to our literature review covering the past 30 years, there have been many researchers for the CRF patients' psychosocial difficulties. Also most of this research work compare treatment strategies with respect to psychiatric morbidity and quality of life.
慢性肾衰竭(CRF)的主要治疗方式是透析和肾移植。根据1997年的数据,土耳其有10000名血液透析患者和1893名持续性非卧床腹膜透析(CAPD)患者。每年进行360例肾移植手术。在决定采用哪种治疗方式时,医学标准仅具有部分重要性。另一方面,就心理社会适应、功能和生活质量而言,即使是专家临床医生也强调很难预测哪种治疗方式对患者最有利。虽然一些研究人员报告称CRF患者的精神疾病发病率和残疾率很高,且所选治疗方式之间没有差异,但大多数研究人员报告称移植比透析更具优势,移植患者的生活质量更好。另一方面,一些研究人员声称,CRF治疗期间心理适应情况会发生变化,精神症状会随时间减轻。本文对CRF患者的精神和社会问题以及这些问题对生活质量的影响进行了综述。根据我们对过去30年文献的回顾,有许多研究关注CRF患者的心理社会困境。而且大多数这项研究工作都比较了不同治疗策略在精神疾病发病率和生活质量方面的差异。