【摘要】目的探讨设置症状管理顾问对维持性血液透析(maintenance hemodialysis，MHD)患者症状群管理的效果。方法选择2017 年6 月2018 年6 月在荆州市第二人民医院血液净化中心行血液透析治疗的130 例患者为研究对象，将2017 年6～12 月未采用症状管理顾问进行症状群管理的65 例患者设为对照组，2018 年1～6 月采用症状管理顾问进行症状群管理的65 例患者设为干预组。比较2 组患者症状群的发生率、患者的生存质量、患者满意度等结局指标。结果干预组患者症状群的发生率低于对照组(尿毒症一般症状群，χ²=43.973，P＜0.001；心肺系统症状群χ²=26.252，P＜0.001；消化道症状群χ2=57.754，P<0.001；情感症状群χ²=34.001，P＜0.001；水电解质症状群χ²=43.726，P<0.001；生存质量得分高于对照组(干预1 个月后，t=4.435，P＜0.001；干预3 个月后，t=15.809，P＜0.001；干预6 个月后，t=30.225，P＜0.001)，满意度得分高于对照组(干预1 个月后，t=19.139，P＜0.001；干预3 个月后，t=20.919，P＜0.001；干预6 个月后，t=5.882，P＜0.001)，差异有统计学意义。结论设置症状管理顾问可降低MHD患者症状群的发生率，提高患者生存质量、患者满意度，值得临床推广应用。

【Abstract】Objective To investigate the effect of setting up symptom management consultants for symptom management in patients with maintenance hemodialysis (MHD). Methods A total of 130 patients undergoing hemodialysis from June 2017 to June 2018 in the Hemodialysis Center, Jingzhou Second People's Hospital were enrolled in this study. Sixty- five patients treated in the period from June to December 2017 without symptom management by the symptom management consultants were included in the control group, and 65 patients treated in the period from January to June 2018 and subjected to symptom management by the symptom management consultants were assigned in the intervention group. The presence of symptom groups, quality of life and satisfaction of the patients were compared between the two groups. Results In the intervention group, the incidences of symptom groups were lower than those in the control group (for general symptom group of uremia, χ²=43.973, P<0.001; for symptom group of cardiopulmonary symptoms, χ²=26.252, P<0.001; for symptom group of digestive symptoms, χ²=57.754, P< 0.001; for symptom group of emotional symptoms, χ²=34.001, P<0.001; for symptom group of water electrolyte, χ²=43.726, P<0.001); the quality of life score was higher than that in the control group (after intervention for one month, t=4.435, P<0.001; for 3 months, t=15.809, P<0.001; for 6 months, t=30.225, P<0.001); and the satisfaction score was also higher than that in the control group (after intervention for one month, t=19.139, P<0.001; for 3 months, t=20.919, P< 0.001; for 6 months, t=5.882, P<0.001). Conclusion The symptom management consultants for symptom management in MHD patients can reduce the incidence of symptoms and improve their quality of life and satisfaction, suitable to be widely used in clinical practice.