山东医药2025，Vol.65Issue(3)：46-50,5.DOI:10.3969/j.issn.1002-266X.2025.03.010
多学科协作诊疗模式对糖尿病肾病维持性血液透析患者生活质量、衰弱状态和血管通路的影响
Effects of MDT model on quality of life,frailty status,and vascular access in patients with diabetic nephropathy undergoing maintenance hemodialysis
摘要
Abstract
Objective To observe the effects of the multidisciplinary team(MDT)model on quality of life,frailty status,and vascular access in patients with diabetic nephropathy(DN)receiving maintenance hemodialysis(MHD).Methods Eighty DN patients undergoing MHD were randomly assigned into the control group of 40 cases and observa-tion group of 40 cases.Patients in the control group received conventional care,while patients in the observation group re-ceived an MDT model.At 3 months post-enrollment,we assessed quality of life using the Generic Quality of Life Inventory-74(GQOLI-74)and frailty status using the Clinical Frailty Scale(CFS).Vascular access(arteriovenous fistulas or long-term catheters)was monitored daily for 3 months.We recorded the dates of access establishment and failure and calculat-ed the access longevity.Blood flow through vascular access was measured at 3 months.Complications during the follow-up period were recorded and we calculated the incidence rates.Results Compared with the control group,the observation group showed significantly higher quality of life scores[(305.00±38.69)vs.(280.50±34.58),P<0.05]and lower frailty scores[(3.15±0.65)vs.(7.35±0.75),P<0.05].The observation group had longer arteriovenous fistula surviv-al,extended long-term catheter patency,and higher blood flow rates(all P<0.05).Additionally,the incidence of compli-cations was significantly lower in the observation group(7.5%vs.32.5%,P<0.05).The incidence of complications was 7.5%in the observation group,and 32.5%in the control group,with statistically significant difference between these two groups(P<0.05).Conclusion The MDT model significantly enhances the quality of life,reduces frailty,prolongs the longevity of vascular access,improves blood flow rates,and minimizes vascular access-related complications in DN pa-tients undergoing MHD.关键词
糖尿病肾病/血液透析/多学科协作诊疗模式/衰弱/血管通路Key words
diabetic nephropathy/hemodialysis/multidisciplinary team model/frailty/vascular access分类
临床医学引用本文复制引用
赵袆,张晓速,李伟,薛森耀..多学科协作诊疗模式对糖尿病肾病维持性血液透析患者生活质量、衰弱状态和血管通路的影响[J].山东医药,2025,65(3):46-50,5.基金项目
国家自然科学基金资助项目(82174179) （82174179）
潍坊市科技发展计划项目(2022YX119) （2022YX119）
潍坊市卫生健康委科研项目(WFWSJK-2023-004). （WFWSJK-2023-004）
