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肾移植患者身体机能与生活质量评估:一项横断面研究。

Assessment of physical performance and quality of life in kidney-transplanted patients: a cross-sectional study.

作者信息

Esposito Pasquale, Furini Francesco, Rampino Teresa, Gregorini Marilena, Petrucci Lucia, Klersy Catherine, Dal Canton Antonio, Dalla Toffola Elena

机构信息

Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Viale Golgi 19, 27100 Pavia, Italy.

Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy.

出版信息

Clin Kidney J. 2017 Feb;10(1):124-130. doi: 10.1093/ckj/sfw102. Epub 2016 Nov 10.

Abstract

BACKGROUND

Information on physical and mental wellness in renal transplantation is limited. Therefore, we performed a cross-sectional study to evaluate and describe the different components of physical performance and quality of life (QoL) in a cohort of kidney-transplanted patients.

METHODS

Physical performance and QoL were determined through the administration of validated tests and questionnaires [muscle strength, dynamometer handgrip, tactile sensitivity, visual analogue scale (VAS) for pain, Timed Up and Go (TUG) test, Fatigue Severity Scale (FSS) and the 36-item Short Form Health Survey]. The patients were divided into three groups based on time elapsed since transplantation: early (in the first 6 months), middle (from 7 to 60 months) and late (>60 months).

RESULTS

Of 132 enrolled patients, 11 patients (8.3%) presented a severe reduction of muscle strength, 63 patients (47%) had significant bilateral impaired handgrip and tactile sensitivity was altered in 23 patients (17.4%). TUG assessment showed significant mobility limitation in 29 patients (21.9%). The FSS presented a pathological value in 50 patients (37.3%), while the mean VAS was 1.8 ± 2.7. There were no significant differences in physical performance parameters among the three patient groups. There were inverse correlations among different components of physical performance and age, comorbidity and dialysis vintage, and there was a direct correlation with renal function. During the first months after transplantation there were limitations in physical, social and emotional activities. Overall, the self-perceived physical performance was significantly lower in transplanted patients with respect to the normal reference level.

CONCLUSION

Kidney-transplanted patients may present different degrees of impairment in physical performance and quality of life. Systematic functional assessment is essential to identify patients needing intensive and personalized rehabilitation programmes.

摘要

背景

肾移植中有关身心健康的信息有限。因此,我们开展了一项横断面研究,以评估和描述一组肾移植患者身体机能和生活质量(QoL)的不同组成部分。

方法

通过实施经过验证的测试和问卷来确定身体机能和生活质量[肌肉力量、握力计测量握力、触觉敏感度、疼痛视觉模拟量表(VAS)、计时起立行走(TUG)测试、疲劳严重程度量表(FSS)以及36项简短健康调查问卷]。根据移植后的时间将患者分为三组:早期(前6个月)、中期(7至60个月)和晚期(>60个月)。

结果

在132名登记患者中,11名患者(8.3%)出现肌肉力量严重下降,63名患者(47%)双侧握力明显受损,23名患者(17.4%)触觉敏感度改变。TUG评估显示29名患者(21.9%)存在明显的活动受限。FSS在50名患者(37.3%)中呈现病理值,而平均VAS为1.8±2.7。三组患者的身体机能参数无显著差异。身体机能的不同组成部分与年龄、合并症和透析时间呈负相关,与肾功能呈正相关。移植后的头几个月,身体、社交和情感活动存在限制。总体而言,移植患者自我感知的身体机能明显低于正常参考水平。

结论

肾移植患者可能在身体机能和生活质量方面存在不同程度的损害。系统的功能评估对于识别需要强化和个性化康复计划的患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e5b/5469555/c133b19becf5/sfw10201.jpg

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