Dialysis Modality Thiab Kev Sib Deev Kev Sib Deev Hauv Cov Txiv Neej
Mar 28, 2022
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
Nihan Tekkarismaz1| Munevver Tunel2| Cevahir Ozer2
Abstract
Kev ua txhaum ntawm kev sib deev yog ib qho teeb meem tsis txaus ntseeg yog vim muaj tsawg tsawg ntawm cov kev tshawb fawb hauv cov ntaub ntawv. Txoj kev tshawb no aims los soj ntsuam covkev sib deev dysfunction-relatedcov teebmeem ntawm kev lim ntshav ntawm cov txiv neej cov neeg mob nrog cmob raum tsis ua haujlwm.Txhua tus neeg mob raug nug kom ua tiav 2 daim ntawv nug: Lub Tsev Kho Mob Ntshai Kev Nyuaj Siab Scale [HADS] thiab International Index of Erectile Function [IIEF-5]. Tag nrho ntawm 51 tus neeg mob uas ua tiav cov lus nug tau suav nrog hauv txoj kev tshawb no. 31 ntawm lawv tau nyob rau hauv kev kho mob hemodialysis (HD), thiab 20 nyob rau hauv kev kho mob peritoneal dialysis (PD). Tom qab hloov kho rau hnub nyoog thiab HADS cov qhab nia, tsis muaj qhov sib txawv tseem ceeb ntawm HD thiab PD pawg raws li cov qhab nia IIEF (55 vs. 40, p=.058), thiab qhov zaus ntawmkev sib deev tsis ua haujlwm(12.9 feem pua vs. 30 feem pua , p=.163). Hnub nyoog (r=−0.553), ntshav siab (r=−0.299/ −0.374), siv hlau ( r=−0.333), lipid theem (r=−0.281/ −{23}}.276) thiab HADS-D qhab nia (r=−0.276) inversely txuam nrog IIEF qhab nia (p < .05).="" los="">kev sib deev tsis ua haujlwmFeem ntau tshwm sim hauv cov neeg mob uas tau txais kev kho PD ntau dua li cov neeg uas tau txais kev kho HD. Cov hnub nyoog laus dua, ntshav siab dua, kev kho mob hlau, qib lipid ntau dua, thiab muaj kev nyuaj siab tau cuam tshuam nrog ntau dua ntawm cov kab mob.kev sib deev tsis ua haujlwm.
KEYWORDSHADS, hemodialysis, IIEF, peritoneal dialysis, kev sib deev dysfunction
cistanche txiv neej cov txiaj ntsigraukev sib deev tsis ua haujlwm
1|Taw qhia
Thoob ntiaj teb,mob raum mob(CKD) tau tshaj tawm tias tshwm sim hauv ntau dua 10 feem pua ntawm cov pej xeem (Fugl-Meyer, Nilsson, Hylander, & Lehtihet, 2017; Guven, Sari, Inci, & Cetinkaya, 2018). CKD cuam tshuam tsis yog rau lub raum nkaus xwb tab sis tag nrho lwm yam tseem ceeb hauv nruab nrog cev thiab lub cev thiab (Fugl-Meyer li al., 2017). Piv nrog rau cov pej xeem, kev sib deev dysfunction (SD) muaj ntau dua ntawm cov neeg mobmob raum tsis ua haujlwm(CRF) (Fugl-Meyer et al., 2017; Guven et al., 2018; Hassan, Elimeleh, Shehadeh, Fadi, & Rubinchik, 2018; Lai et al., 2007; Savadi, Khaki, Javnbakht, & Pourrafie, ). Kev sib deev tsis zoo tuaj yeem pom los ntawm cov theem pib ntawm cov kab mob raum ntev (Guven li al., 2018). Kev ua txhaum ntawm kev sib deev hauv CKD yog ib qho teeb meem nyuaj uas tuaj yeem cuam tshuam los ntawm ob qho tib si physiological thiab psychosocial yam (Theofilou, 2012). Muaj ntau yam xws li ntshav qab zib, kab mob plawv, kab mob neurological,kev sib deev hormonal ntshawv siab, thiab cov kev mob tshwm sim tuaj yeem ua rau SD (Fugl-Meyer li al., 2017; Hassan li al., 2018; Palmer, 1999, 2003; Savadi li al., 2016). Muab hais tias muaj ntau yam zoo li no tshwj xeeb tshaj yog nyob rau hauv cov neeg mob CRF, nws tsis yog qhov xav tsis thoob tias SD feem ntau tshwm sim hauv pawg neeg mob no.
Txawm li cas los xij, txawm hais tias nws muaj ntau heev, SD feem ntau tsis raug tshuaj xyuas lossis kuaj pom. Muaj tsawg tsawg ntawm cov kev tshawb fawb hauv cov ntaub ntawv uas saib rau hauv ib qho kev sib raug zoo ntawm txoj kev lim ntshav thiab SD ntawm cov neeg mob CRF. Txoj kev tshawb no yog tsom rau kev soj ntsuam cov txiaj ntsig ntawm kev lim ntshav rau kev ua haujlwm ntawm kev sib deev ntawm cov txiv neej CRF cov neeg mob.
2|Cov khoom siv thiab cov txheej txheem
Txoj kev tshawb no tau pom zoo los ntawm Baskent University Institutional Review Board (Project: KA19/327) thiab txhawb nqa los ntawm Baskent University Research Fund. Txoj kev tshawb no tau ua raws li cov hauv paus ntsiab lus ntawm Kev Tshaj Tawm ntawm Helsinki. Cov ntaub ntawv tso cai tau txais los ntawm txhua tus neeg koom.
2.1|Cov neeg koom nrog
Cov kws sau ntawv tau ua qhov kev tshuaj xyuas ntu ntu txij lub Yim Hli 2019 txog Lub Kaum Hli 2019.
The inclusion criteria were as follows: (a) patients who were >Hnub nyoog 18 xyoo (b) txiv neej poj niam txiv neej (c) kev kho mob lim ntshav (hemodialysis (HD) lossis peritoneal dialysis (PD)) tsawg kawg yog 3 lub hlis ntawm Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob Nephrology, Tsev Kho Mob Baskent University, Adana, Qaib ntxhw, (d) muaj tus khub sib deev thiab (e) muaj peev xwm nkag siab thiab teb cov lus nug.
Cov txheej txheem cais tawm muaj raws li hauv qab no: (a) cov neeg mob tau hloov pauv kev lim ntshav los ntawm HD mus rau PD lossis rov ua dua, (b) muaj keeb kwm hloov pauv lub raum, (b) muaj cov kab mob puas siab puas ntsws loj, muaj kab mob nquag (xws li peritonitis) lossis tsis tswj lub plawv tsis ua haujlwm. thiab (c) muaj keeb kwm ntawm cawv lossis yeeb tshuaj.
Tshaj li 3 lub hlis ntawm txoj kev tshawb no, 108 tus txiv neej CRF cov neeg mob uas ua tau raws li cov txheej txheem suav nrog raug caw tuaj rau hauv daim ntawv ntsuam xyuas. Txawm li cas los xij, 48 tus neeg mob tsis kam koom thiab, tsuas yog 60 tus neeg tau txais kev koom tes. Ntawm lawv, 3 tus neeg mob tsis ua tiav daim ntawv nug. Rau cov neeg mob los ntawm pawg PD raug cais tawm vim lawv muaj hnub nyoog laus dua piv rau pawg HD, thiab yog li, tag nrho, 51 tus txiv neej cov neeg mob tau suav nrog hauv txoj kev tshawb no.
Cov neeg mob cov yam ntxwv suav nrog hnub nyoog, qhov siab, qhov hnyav, lub cev qhov hnyav (BMI), tus cwj pwm haus luam yeeb, tso zis ntim, lub sijhawm ntawm kev lim ntshav, qib ntshav siab, kev txij nkawm, qib kev kawm, kev ua haujlwm, thawj lub raum kab mob, cov kab mob comorbid (diabetes mellitus, ntshav siab, kab mob plawv, kab mob pulmonary, thiab kab mob cerebrovascular) thiab keeb kwm parathyroidectomy tau sau tseg.
Cov tshuaj kho mob (cov tshuaj tiv thaiv ntshav siab suav nrog angiotensin-hloov enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, alpha-blockers thiab diuretics, cov tshuaj uas cuam tshuam rau kev lim ntshav suav nrog erythropoietin, hlau thiab vitamin-D, thiab cov tshuaj lipid-txo qis. ) tau muab los ntawm cov neeg mob cov ntaub ntawv.
Biochemical thiab hematological tsis suav nrog cov ntshav creatinine, hemoglobin, ferritin, C-reactive protein, calcium, phosphorus, albumin, parathyroid hormone, lipid qib thiab Kt / V (ib qho qhia txog kev lim ntshav txaus) tau txais los ntawm ib nrab lub lim tiam ua ntej lim ntshav kuaj ntshav. nyob rau hauv 1 lub hlis ntawm kev kawm no. Rau Kt/V urea Performance index, qhov tseem ceeb hauv qab 1.2 tau suav tias yog qhov txawv txav rau cov neeg mob HD; Cov txiaj ntsig rau PD tau suav tias yog qhov txawv txav hauv qab 1.7.
2.2|Cov lus nug
Tus kws kho mob nephrology tau ntsib ntsej muag nrog txhua tus neeg koom nrog. Kev xam phaj tau muaj nyob rau lub sijhawm niaj hnub HD cov rooj sib tham lossis kev tswj hwm polyclinic niaj hnub rau cov neeg mob PD. Rau kev ceev ntiag tug tus neeg mob, cov lus nug tau muab rau cov neeg koom nrog hauv lub hnab ntawv kaw thiab khaws rov qab rau hauv lub hnab ntawv kaw. Tom qab sau ntawv tso cai tau txais, txhua tus neeg mob raug nug kom ua tiav ob daim ntawv nug ntawm lawv tus kheej: (a) Tsev Kho Mob Ntshai Txog Kev Nyuaj Siab (HADS), thiab (b) International Index of Erectile Function (IIEF-5). Cov lus nug uas tau sau los ntawm cov neeg koom tau raug soj ntsuam los ntawm urology thiab kws kho mob hlwb.
2.2.1|HADS
Qhov mob hnyav ntawm kev ntxhov siab thiab kev nyuaj siab ntawm cov neeg koom tau raug soj ntsuam siv HADS (Zigmond & Snaith, 1983). Kev siv tau thiab kev ntseeg tau ntawm cov nplai hauv lus Turkish tau ua tiav (Aydemir, 1997). Qhov ntsuas muaj tag nrho ntawm 14 cov lus nug. Cov lus nug txawv txawv yog tsim los ntsuas kev ntxhov siab (xws li kev ntxhov siab subscale HADS-A) thiab cov lej txawm tias yog rau kev nyuaj siab (xws li kev nyuaj siab subscale HADS-D). Raws li qhov tshwm sim ntawm kev tshawb fawb hauv tebchaws Turkey, qhov kev txiav tawm rau HADS-A tau txiav txim siab ua 10 ntawm 11, thiab cov qhab nias txiav tawm rau HADS-D tau txiav txim siab ua 7 ntawm 8. qis tshaj thiab cov qhab nia siab tshaj plaws ntawm ob qhov subscales yog, feem, 0 thiab 21 (Aydemir, 1997).
2.2.2|IIEF
SD ntawm cov neeg koom tau raug soj ntsuam siv IIEF (Rosen li al., 1997). IIEF yog cov cuab yeej siv dav thiab siv tau. Nws tau muab txhais los ntawm lus Askiv rau Turkish. Cov lus hauv cheeb tsam siv tau thiab kev ntseeg tau ntawm daim ntawv nug txhais lus no tau raug pov thawj hauv kev tshawb fawb Turkish yav dhau los (Bayraktar, 2{{10}}}17). Nws muaj 15 lo lus nug los soj ntsuam kev ua haujlwm ntawm kev sib deev hauv cov txiv neej hauv tsib lub ntsiab lus, suav nrog kev ua haujlwm erectile (Ntu 1–5 thiab nqe lus nug 15; cov qhab nia ntau: 1–30), orgasm function (Lus Nug 9 thiab 1{{51} } }; cov qhab nia ntau: 0–10), kev ntshaw kev sib deev (Lus Nug 11 thiab 12; tau qhab nia ntau: 2–10), kev txaus siab nrog kev sib deev (Lus Nug 6–8; tau qhab nia ntau: 0–15) thiab tag nrho kev sib deev txaus siab (Ntu 13 –14; cov qhab nees: 2–10) (Martin-Diaz, Reig-Ferrer, & Ferrer-Cascales, 2006; Savadi li al., 2016). Txhua lo lus nug muaj rau 6 txoj kev xaiv, thiab nyob ntawm qhov kev xaiv xaiv, lawv muaj cov qhab nia ntawm 0–5 (Savadi li al., 2016). Dhau li ntawm cov qhab nia sau npe, daim ntawv nug tseem muaj cov qhab nia thoob ntiaj teb uas tau txais hauv txhua yam khoom (cov qhab nia ntau: 5–75). Ib qho kev txiav tawm tag nrho IIEF qhab nia ntawm 25 (ntau ntawm cov qhab nia ntawm 5 txog 75) tau siv los txhais 'Sexual Dysfunction'. Kev txiav tawm ntawm 21 (ntau ntawm cov qhab nia ntawm 5–25) tau siv los txhais 'Erectile Disorder' (Rosas li al., 2001). Tag nrho cov qhab nia ua haujlwm erectile tau muab faib ua tsis muaj ED (26–30), me ED (22–25), me me rau nruab nrab (17–21), nruab nrab ED (11–16) thiab hnyav ED (0–10). Peb tau sau thiab txheeb xyuas cov lus teb rau cov lus nug.
2.3|Kev txheeb cais
Kev txheeb xyuas txheeb cais tau ua tiav siv cov ntaub ntawv txheeb xyuas pob SPSS software (version 25.0, SPSS Inc.). Yog tias qhov sib txawv tsis tu ncua yog qhov qub, lawv tau piav qhia raws li qhov nruab nrab ± tus qauv sib txawv (p > .05 hauv Kolmogorov-Smirnov test lossis Shapira-Wilk (n <30)), thiab="" yog="" tias="" qhov="" sib="" txawv="" tsis="" tu="" ncua="" tsis="" zoo="" li="" qub,="" lawv="" tau="" piav="" qhia="" raws="" li="" qhov="" nruab="" nrab.="" kev="" sib="" piv="" ntawm="" cov="" pab="" pawg="" tau="" siv="" los="" siv="" cov="" tub="" ntxhais="" kawm="" t-test="" (pawg:="" hd="" &="" pd)="" rau="" ib="" txwm="" faib="" cov="" ntaub="" ntawv="" thiab="" mann–the="" whitney="" u="" test="" tau="" siv="" rau="" cov="" ntaub="" ntawv="" tsis="" nquag="" faib.="" cov="" categorical="" variables="" ntawm="" cov="" pab="" pawg="" tau="" soj="" ntsuam="" los="" ntawm="" kev="" siv="" chi-square="" test="" los="" yog="" fisher's="" exact="" test.="" tus="" nqi="" ntawm="" p="">< .05="" raug="" suav="" hais="" tias="" yog="" kev="" txheeb="" cais.="" peb="" tau="" ua="" spearman="" qhov="" sib="" txheeb="" coefficients="" los="" ntsuas="" kev="" sib="" koom="" ua="" ke="" ntawm="" daim="" ntawv="" nug="" iief="" thiab="" cov="" kev="" kuaj="">
3|TSEEM CEEB
Tag nrho ntawm 51 tus txiv neej cov neeg mob (qhov nruab nrab hnub nyoog 50.5 ± 9.1 xyoo) tau suav nrog hauv txoj kev tshawb no. 31 ntawm lawv tau nyob rau hauv kev kho mob HD (qhov nruab nrab hnub nyoog yog 48.5 ± 7.4 xyoo), thiab 20 nyob rau hauv PD kev kho mob (qhov nruab nrab hnub nyoog yog 53.6 ± 10.8 xyoo). Lub sijhawm nruab nrab ntawm kev lim ntshav ua ntej txoj kev tshawb fawb yog 58 (min 6- max 276) lub hlis rau txhua tus neeg koom. Mob ntshav qab zib mellitus thiab kub siab muaj nyob rau hauv 25.5 feem pua thiab 82.4 feem pua ntawm cov neeg mob feem. Cov neeg mob tau txheeb xyuas ua ob pawg, pawg HD thiab pawg PD. Txhua tus neeg mob hauv pab pawg HD tau txais kev kho HD peb zaug hauv ib lub lis piam, rau 4 teev hauv txhua qhov kev lim ntshav. Txhua tus neeg mob hauv pawg PD tau txais kev kho mob peritoneal dialysis tas li.
3.1|Kev sib piv ntawm cov yam ntxwv hauv qab ntawm cov neeg mob HD thiab PD
Kev kawm qib siab dua (p=.001), thiab cov neeg poob hauj lwm qis dua (p=.007) hauv PD pawg. Lwm yam kev kho mob tau teev tseg hauv Table 1. Muaj ntau tus neeg mob noj cov tshuaj beta-blockers (p=.009) thiab ntau dua 2 tshuaj (p=.015) rau kev kho mob ntshav siab hauv pawg PD . Cov neeg koom nrog cov tshuaj tau muab rau hauv Table 2. Cov qib ntawm hemoglobin (p=.012) thiab ntshav albumin (p=.000) qis dua hauv cov neeg mob PD. Cov qib ntawm tag nrho cov roj (cholesterol) (p=.036) thiab LDL cholesterol (p=.041) yog siab dua hauv cov neeg mob PD. Txawm hais tias tus nqi Kt / V tau siab dua hauv pawg PD (p=.000), thaum tus nqi ntawm cov neeg mob uas ua tiav lub hom phiaj Kt / V tau muab piv, tsis muaj qhov sib txawv ntawm ob pawg. (Table 3).
3.2|Kev sib piv ntawm HADS cov qhab nia ntawm HD thiab PD cov neeg mob
Txhua tus neeg mob cov qhab nia HADS-A thiab HADS-D cov qhab nia tau pom tias yog 6.98 ± 3.28 thiab 7.84 ± 3.99 raws li. Qhov tshwm sim ntawm kev nyuaj siab yog 51 feem pua (n: 26), thiab kev ntxhov siab yog 11.8 feem pua (n: 6).
Tsis muaj qhov sib txawv ntawm cov neeg mob HD thiab PD raws li cov qhab nia HADS-D (p=.880) thiab HADS-A cov qhab nia (p=.569). Raws li cov qhab nias txiav tawm, tsis muaj qhov sib txawv ntawm ob pawg ntawm kev nyuaj siab (p=1.00) thiab kev ntxhov siab (p=1.00) (Table 4).
3.3|Kev sib piv ntawm IIEF cov qhab nia ntawm HD thiab PD cov neeg mob
Qhov tshwm sim ntawm SD yog 19.6 feem pua (n: 10) hauv txhua tus neeg mob. Cov txiaj ntsig ntawm IIEF daim ntawv ntsuam xyuas ntawm cov neeg koom tau nthuav tawm hauv Table 5. Tsis muaj qhov sib txawv tseem ceeb ntawm ob pawg ntawm cov qhab nia IIEF (p=.058) thiab SD raws li cov qhab nia txiav tawm (30 feem pua vs. 13 feem pua , p=.163).
3.4|Kev sib piv kev soj ntsuam ntawm ib qho ntawm erectile muaj nuj nqi ntawm HD thiab PD cov neeg mob
Tsis muaj qhov sib txawv ntawm qhov sib txawv ntawm ED tus nqi ntawm peb pawg HD thiab PD (58 feem pua vs. 65 feem pua, p=.771). Tus nqi tsis muaj ED, me ED, me me mus rau nruab nrab ED, nruab nrab ED thiab hnyav ED tau pom muaj li 15 feem pua, 20 feem pua, 25 feem pua, 5 feem pua thiab 35 feem pua, raws li, nyob rau hauv peb cov neeg mob PD, thiab 25.8 feem pua, 16.1 feem pua , 25.8 feem pua , 22.6 feem pua thiab 9.7 feem pua, feem, hauv peb cov neeg mob HD. Tsis muaj qhov sib txawv tseem ceeb ntawm pawg HD thiab PD raws li qib ED (p=.129).
3.5|Kev txheeb xyuas kev sib raug zoo ntawm qhov chaw kho mob thiab cov qhab nia IIEF
Cov hnub nyoog Advanced, siab systolic thiab diastolic ntshav siab, siab tag nrho cov roj cholesterol, kev kho hlau thiab cov qhab nia HADS-D siab tau pom tias muaj feem cuam tshuam nrog cov qhab nia IIEF qis dua. Tsis tas li ntawd, cov hnub nyoog siab tshaj, siab BMI, siab systolic thiab diastolic ntshav txaus siab, kho hlau, tsis siv cov vitamin-D kho, siab tag nrho cov roj cholesterol thiab triglyceride thiab cov qhab nia HADS-D siab tau cuam tshuam nrog ib lossis ntau qhov ntawm IIEF (Table 6. ).
3.6|Kev sib piv ntawm cov neeg mob uas muaj thiab tsis muaj SD
Cov hnub nyoog siab tshaj tau pom tias yog qhov muaj feem pheej hmoo rau SD (48.8 vs. 57.5, p=.006). Systolic (127 vs. 141 mmHg, p=.025) thiab diastolic (76 vs. 82 mmHg, p=.050) ntshav siab hauv peb cov neeg mob SD tau siab dua cov tsis muaj SD. Tsis muaj qhov sib txawv tseem ceeb ntawm peb cov neeg mob uas muaj thiab tsis muaj SD raws li lub sijhawm lim ntshav, BMI, cov zis ntim, ntshav creatinine, hemoglobin, ferritin, C-reactive protein, calcium, phosphorus, albumin, parathyroid hormone, cholesterol, lipid qib thiab Kt. /V.
4|Kev sib tham
Qhov kev tshawb fawb hauv cheeb tsam yav tom ntej no piv rau txiv neej kev ua haujlwm ntawm kev sib deev siv IIEF ntawm HD thiab PD cov neeg mob thiab tshawb xyuas kev koom tes ntawm IIEF thiab kev kho mob. Raws li cov kev tshawb fawb yav dhau los, cov hnub nyoog siab tshaj thiab nce kev nyuaj siab thiab kev ntxhov siab yog paub tias yog ib qho tseem ceeb ntawm kev pheej hmoo rau kev sib deev dysfunction. Vim li no, kev tshuaj xyuas tau ua tom qab kho ob pawg ntawm cov hnub nyoog thiab HADS cov qhab nia. Raws li qhov tshwm sim, peb pom tias kev ua txhaum ntawm kev sib deev muaj ntau dua rau cov neeg mob uas tau txais kev kho mob PD dua li cov uas tau txais kev kho HD. Peb kuj pom tias muaj hnub nyoog laus dua, ntshav siab dua, qib lipid ntau dua thiab muaj kev nyuaj siab tau cuam tshuam nrog kev sib deev ntau dua.
Qhov qhab nia HADS-A (6.9 vs. 5.8, 6.7) thiab qhov qhab nia HADS-D (7.8 vs. 5.6, 7.6) ntawm peb cov neeg mob tau zoo ib yam li cov lus qhia yav dhau los (Balaban et al., 2017; Guven et al. , 2018). Hauv ntau cov kev tshawb fawb uas muaj cov neeg mob HD, qhov qhab nia nruab nrab IIEF tau tshaj tawm tias nyob hauv thaj tsam ntawm 39. . Qhov qhab nia nruab nrab IIEF ntawm peb cov neeg mob HD zoo ib yam li cov kev tshawb fawb no. Hauv kev tshawb fawb txog cov neeg mob PD, qhov qhab nia nruab nrab IIEF tau tshaj tawm tias yog 33.4 (Azevedo li al.., 2014). Qhov qhab nia nruab nrab IIEF ntawm peb cov neeg mob PD yog me ntsis siab dua piv nrog txoj kev tshawb no.
Lai et al tau tshaj tawm tias cov qhab nia nruab nrab ntawm IIEF domains suav nrog kev ua haujlwm ntawm erectile, kev ua haujlwm ntawm orgasm, kev xav ntawm kev sib deev, kev txaus siab ntawm kev sib deev thiab kev sib deev tag nrho yog li 25, 10, 6, 8 thiab 7.5, raws li, hauv cov txiv neej cov neeg mob PD (Lai et al. Ib., 2007). Peb pom peb cov neeg mob PD 'IIEF subdomains qhab nia qis dua Lai thiab cov neeg mob 'IIEF subdomains qhab nia. Thaum IIEF subdomains qhab nia ntawm peb pawg PD tau muab piv nrog rau IIEF subdomains qhab nia ntawm peb pawg HD, IIEF sub-domains qhab nia ntawm peb pawg PD tau qis dua. Vim yog lub catheter hauv cheeb tsam plab hauv cov neeg mob PD, cov teeb meem puas siab puas ntsws xws li lub cev dysmorphic tsis meej thiab tsis muaj peev xwm hloov mus rau cov qauv zoo nkauj hauv zej zog tuaj yeem ua rau muaj kev sib deev. Tsis tas li ntawd, kev txhawj xeeb txog qhov muaj peev xwm ntawm catheter hloov chaw hauv pawg neeg mob PD tuaj yeem ua rau txo qis libido (Kwan, 1999).
Cov kev tshawb fawb yav dhau los tau tshaj tawm tias qhov zaus ntawm SD hauv cov txiv neej nrog CRF yog nyob nruab nrab ntawm 20 feem pua thiab 80 feem pua (Fugl-Meyer li al., 2017). Azevedo thiab al qhia qhov zaus ntawm SD li 44.8 feem pua , hauv txiv neej pa tients ntawm PD (Azevedo li al., 2014). Peb pom qhov zaus ntawm SD kuj qis dua hauv peb cov neeg mob PD.
Qhov zaus ntawm ED hauv cov neeg mob CRF tau tshaj tawm tias nyob nruab nrab ntawm 70 feem pua thiab 86 feem pua (Fernandes li al., 2010; Navaneethan et al., 2010). Qhov tshwm sim ntawm ED tau tshaj tawm tias yog 70 feem pua ntawm cov metanalysis uas suav nrog 21 kev tshawb fawb thiab 4,389 tus neeg mob (Navaneethan li al., 2010). Tus nqi ED ntawm txhua tus neeg mob zoo ib yam li cov ntaub ntawv. Hauv cov kev tshawb fawb yav dhau los, qhov tshwm sim ntawm ED tau raug tshaj tawm ntawm tus nqi sib txawv, xws li 51.9 feem pua rau 88 feem pua ntawm cov neeg mob PD (Lai li al., 2007; Savadi li al., 2016) thiab 72.3 feem pua -87.5 feem pua hauv cov neeg mob HD ( Collaborative et al.., 2012; Fernandes et al., 2010; Rosas et al., 2001; Savadi et al., 2016). Thaum qhov ntau ntawm ED zoo ib yam li cov ntaub ntawv hauv peb cov neeg mob PD, nws qis dua hauv peb cov neeg mob HD.
Hauv kev tshawb fawb sib piv HD thiab PD cov neeg mob hais txog SD, nws tau tshaj tawm hauv 43 feem pua ntawm cov neeg mob HD thiab hauv 25 feem pua ntawm cov neeg mob PD (Toorians li al., 1997). Tab sis hauv txoj kev tshawb no, tsis zoo li peb li, SD tau soj ntsuam nrog Diagnostic and Statistical Manual of Mental Disorders (DSM III). Hauv kev sib piv, tsis muaj qhov sib txawv tseem ceeb ntawm cov neeg mob HD thiab PD cov neeg mob raws li ED (Navaneethan li al., 2010). Ib yam li ntawd, tsis muaj qhov sib txawv ntawm qhov sib txawv ntawm ED ntawm peb pawg HD thiab PD.
Hauv ntau cov kev tshawb fawb yav dhau los, cov hnub nyoog siab thiab kev puas siab puas ntsws xws li kev nyuaj siab thiab kev ntxhov siab tau pom tias muaj kev cuam tshuam loj rau SD. Hauv peb txoj kev tshawb fawb, peb tau hloov kho HD thiab PD cov pab pawg neeg mob raws li kev nyuaj siab, kev ntxhov siab thiab hnub nyoog. Raws li qhov tshwm sim, peb pom tias qhov zaus ntawm SD tau siab dua hauv cov neeg mob hauv pawg PD, txawm tias nws tsis yog qhov tseem ceeb. Cov laj thawj rau qhov no yuav yog qhov siab dua ntawm kev siv beta-blocker pab pawg tshuaj tiv thaiv ntshav siab thiab muaj tus lej siab dua ntawm cov ntshav ntshav, hypoalbuminemia thiab hyperlipidemia hauv cov neeg mob PD. Qhov zoo siab, peb cov neeg mob PD uas muaj SD ntau dua nyob rau hauv kev kawm thiab kev poob haujlwm qis dua.
Piv nrog rau qib ED ntawm peb cov neeg mob PD thiab kev kawm ntawm Lai li al. (Lai et al., 2007), peb tus neeg mob uas ib txwm ua haujlwm erectile qis dua (15 feem pua vs. 48 feem pua), peb tus neeg mob me ED zoo sib xws (18.5 feem pua vs. 20 feem pua), thiab peb cov neeg mob uas mob hnyav ED yog siab dua (35 feem pua vs. 9.3 feem pua). Piv nrog rau qib ED ntawm peb cov neeg mob HD thiab txoj kev tshawb fawb ua los ntawm Martín-Díaz li al.(Martin-Diaz li al., 2006), peb cov neeg mob uas muaj kev ua haujlwm erectile ib txwm muaj (25.8 feem pua vs.. 40 feem pua) thiab mob ED ( 16.1 feem pua vs.. 34.5 feem pua ) tau qis dua, thiab peb cov nqi ntawm cov neeg mob ED hnyav (9.7 feem pua vs.. 9.1 feem pua) tau zoo sib xws.
Cov hnub nyoog siab tshaj tau raug tshaj tawm tias muaj kev pheej hmoo rau SD hauv ntau qhov kev tshawb fawb hauv cov neeg mob CRF (Fernandes li al., 2010; Guven et al., 2018; Lai et al., 2007; Martin-Diaz li al., 2006; Navaneethan et al. al., 2010; Peng et al., 2007; Rosas et al., 2001). Zoo ib yam li cov kev tshawb fawb no, hauv peb txoj kev tshawb fawb, cov hnub nyoog qib siab tau cuam tshuam nrog SD thiab pom tias yog ib qho kev pheej hmoo rau SD. Nyob rau hauv cov ntaub ntawv, peb muaj peev xwm nrhiav tau ib txoj kev tshawb fawb txog PD cov neeg mob uas muaj hnub nyoog tsis yog ib qho kev pheej hmoo rau SD (Azevedo li al., 2014). Lub sijhawm ntev ntawm kev lim ntshav tau tshaj tawm tias yog qhov muaj feem pheej hmoo rau ED hauv kev tshawb fawb (Martin-Diaz li al., 2006). Txawm li cas los xij, hauv peb txoj kev tshawb fawb, lub sijhawm lim ntshav tsis tau txiav txim siab ua qhov pheej hmoo rau SD.
Nyob rau hauv cov ntaub ntawv, muaj cov comorbidities xws li ntshav qab zib, ntshav siab thiab kab mob plawv tau tshaj tawm tias yog ib qho kev pheej hmoo rau ED (Fernandes li al., 2010; Guven et al., 2018; Lai et al., 2007; Martin-Diaz et al. ., 2006; Navaneethan et al., 2010; Peng et al., 2007; Rosas et al., 2001). Txawm li cas los xij, hauv peb txoj kev tshawb fawb, qhov muaj kev sib txuam tsis tau pom tias yog qhov muaj feem cuam tshuam rau SD.
Hauv ib txoj kev tshawb fawb txog cov tshuaj tiv thaiv hypertensive, qhov cuam tshuam tsis zoo tshaj plaws ntawm kev sib deev ua haujlwm tau pom nrog alpha-blockers. Tsis muaj qhov tsis zoo ntawm beta-blockers, angiotensin-hloov enzyme inhibitors thiab calcium channel blockers tau pom. Cov nyhuv ntawm angiotensin receptor blockers tau pom tias tsis muaj tseeb. Cov tshuaj vasodilator tau pom tias yog cov tshuaj muaj txiaj ntsig zoo tshaj plaws rau SD (Bailie li al., 2007). Hauv peb txoj kev tshawb fawb, tsis muaj kev sib raug zoo ntawm cov tshuaj antihypertensive thiab SD. Txawm li cas los xij, kev siv cov hlau kho thiab tsis noj cov vitamins D tau cuam tshuam nrog SD.
Hauv kev tshawb fawb txog cov neeg mob PD, ib yam li hauv peb txoj kev tshawb fawb, qib creatinine, calcium thiab phosphorus tau pom zoo sib xws ntawm cov neeg muaj thiab tsis muaj SD. Tsis tas li ntawd, qib ntawm albumin tau tshaj tawm tias tsis muaj kev pheej hmoo (Azevedo li al., 2014). Txawm li cas los xij, qib qis albumin tau tshaj tawm tias yog qhov muaj feem cuam tshuam rau ED hauv qee qhov kev tshawb fawb (Martin-Diaz li al., 2006; Peng li al., 2007). Hauv peb txoj kev tshawb fawb, qib albumin tsis pom muaj qhov pheej hmoo rau SD. Hauv kev tshawb fawb, nws tau hais tias tus nqi Kt / V tsis yog qhov pheej hmoo rau SD (Peng li al., 2007). Ib yam li ntawd, hauv peb txoj kev tshawb fawb, tus nqi Kt / V tsis pom tias yog qhov pheej hmoo.
Txij li lub sijhawm ua ntej lim ntshav, qhov muaj kev nyuaj siab thiab kev ntxhov siab tau pom tias muaj feem cuam tshuam rau SD hauv cov txiv neej cov neeg mob (Guven li al., 2018). Hauv kev kawm, suav nrog 84 HD thiab 60 PD cov neeg mob, uas tau siv daim ntawv nug General Health-28; Kev sib deev ua haujlwm tau pom muaj kev cuam tshuam cuam tshuam nrog kev nyuaj siab thiab kev ntxhov siab (Theofilou, 2012). Ib yam li ntawd, kev nyuaj siab tau raug tshaj tawm tias yog ib qho kev pheej hmoo txaus ntshai rau kev txhim kho ED (Fernandes li al., 2010; Navaneethan et al., 2010). Ib yam li ntawd, peb pom hauv peb txoj kev tshawb fawb pom tias muaj kev nyuaj siab cuam tshuam nrog SD. Hauv lwm txoj kev tshawb fawb nrog cov neeg mob PD, Nws tau tshaj tawm tias HADS cov qhab nia tsis yog qhov pheej hmoo rau SD (Azevedo li al., 2014). Ib yam li ntawd, hauv peb cov neeg mob PD, HADS-D thiab HADS-A cov qhab nia tsis pom tias yog ib qho kev pheej hmoo rau SD.
Peb txoj kev tshawb fawb suav nrog tsuas yog cov txiv neej Turkish. Cov pej xeem hauv txhua lub teb chaws txawv kev coj noj coj ua thiab kev noj qab haus huv ntawm ib leeg. Kev coj cwj pwm kev sib deev kuj raug cuam tshuam los ntawm tus cwj pwm ntsig txog yam xws li kev cai dab qhuas. Cov kev tsis txaus siab txog SD feem ntau tsis qhia rau tus kws kho mob feem ntau vim yog kev sib raug zoo thiab kev coj noj coj ua. Txog niaj hnub no, tsuas yog qee qhov kev tshawb fawb tau hais txog qhov cuam tshuam ntawm kev lim ntshav ntawm kev hloov pauv hauv SD hauv cov neeg mob CRF.
Txoj kev tshawb no muaj qee qhov kev txwv thiab muaj zog. Peb cov neeg mob tau qis qis vim tias kev koom tes hauv kev tshawb fawb txog kev sib deev muaj tsawg heev. Tsis tas li ntawd, cov txiaj ntsig hormonal uas yuav cuam tshuam rau kev sib deev ua haujlwm hauv CRF tsis raug tshuaj xyuas hauv peb txoj kev tshawb fawb. Txawm li cas los xij, hauv txoj kev tshawb no uas qhov kev lim ntshav txaus tau ntsuas ntau thiab cov qauv lim ntshav kuj tau muab piv, cov teeb meem tseem ceeb cuam tshuam rau SD, xws li kev nyuaj siab thiab kev ntxhov siab, tau soj ntsuam ntau los ntawm daim ntawv nug. Cov no tej zaum yuav suav hais tias yog ib qho kev sib haum xeeb ntawm peb txoj kev kawm.
5|XAIV
Kev sib deev tsis sib haum xeeb muaj ntau dua rau cov txiv neej cov neeg mob nrog CRF uas tau txais kev kho PD dua li cov uas tau txais kev kho HD. SD yog ib qho mob ntau yam thiab muaj feem cuam tshuam nrog cov hnub nyoog laus, ntshav siab dua, qib lipid ntau dua, kev kho hlau thiab muaj kev nyuaj siab.
TSEEM CEEB
Peb ua tsaug rau peb cov kws saib xyuas mob hemodialysis thiab peritoneal dialysis rau lawv txoj kev pab.
Los ntawm: 'Dialysis modality thiab kev sib deev dysfunction nyob rau hauv txiv neej cov neeg mob' los ntawmNihan Tekkarismaz1| Munevver Tunel2| Cevahir Ozer2
---Andrologia. Xyoo 2020; 52: e13735
