维持性血液透析患者最佳握力获得方法的探讨  

Discussion how to get the best handgrip strength in maintenance hemodialysis patients

作　　者：祝巍 张贺 孙康 何海硕 赵雪红 郭千庆 ZHU Wei;ZHANG He;SUN Kang(Dept.of Nephrology,No.150 Hospital of PLA,Luoyang,Henan 471000,China)

机构地区：[1]解放军150医院肾内科,河南洛阳471000

出　　处：《实用医药杂志》2018年第10期888-891,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨获得维持性血液透析患者最佳握力(handgrip strength,HGS)的方法。方法测量92例维持性血液透析患者握力,时机选择为透析前后、不同透析间隔,分别测量双手握力,并观察握力对动静脉内瘘影响。结果 (1)内瘘在主力手的患者共24例,主力手握力均值(26.41±7.96) kg,非主力手(24.92±7.87) kg,两者比较有统计学差异。(2)全部患者透析前后两手握力比较,非造瘘手透析前后握力均值分别为(28.43±8.96) kg、(27.60±8.67) kg,造瘘手为(26.73±8.81) kg、(24.89±8.51) kg,透析后两手握力均明显降低且P<0.05。透析后造瘘手握力较非造瘘手握力降低更明显且P<0.05。(3)每周3次透析频次血液透析患者30例,短透析间隔和长透析间隔为握力均值分别为(29.10±9.29) kg、(28.18±8.18) kg;每2周透析5次患者34例,短、长间隔握力均值分别为(28.08±9.21)kg、(28.11±9.63) kg;每周2次透析频次患者28例,短、长间隔握力均值分别为(27.54±7.63) kg、(27.49±7.88) kg,不同透析频率不同透析间隔握力比较差异均无统计学意义。结论为获得最佳握力,透析前进行握力测量优于透析后。测量手建议选择主力手,即使动静脉内瘘位于主力手,其握力仍明显高于非主力手。该研究没有发现透析长短间隔对握力的影响。Objective To explore how to get the best handgrip strength in maintenance hemodialysis patients.Methods The handgrip strength of 92 maintenance hemodialysis patients was measured.The opportunity of finish HGS of both hands was before and after dialysis,at different dialysis intervals.The influence of grip force on internal arteriovenous fistula was observed.Results 1)There were 24 patients whose iAVF were located at the dominant arm.The average HGS value of the dominant arm was(26.41±7.96)kg,and the non-dominant arm was(24.92±7.87)kg.There was significant difference between both.2)Compared with the HGS in all the dialysis patients,the value from non-AVF arm was(28.43±8.96)kg before dialysis and(27.60±8.67)kg after dialysis.The value from iAVF arm was(26.73±8.81)kg before dialysis and(24.89±8.51)kg after dialysis.There is significant HGS decrease in both non-AVF and iAVF arm(P<0.05).The HGS decrease in iAVF arm was more than non-AVF arm(P<0.05).3)There were 30 patients on three times-weekly haemodialysis.The average HGS value of short dialysis interval and long dialysis interval were(29.10±9.29)kg,(28.18±8.18)kg,respectively;34 cases were dialyzed 5 times every 2 weeks,the mean values of short and long interval were(28.08±9.21)kg,(28.11±9.63)kg,respectively.28 patients on 2 times per week,the mean values were(27.54±7.63)kg,(27.49±7.88)kg,respectively.There was no significant difference between different dialysis intervals,no matter what the frequency of dialysis was.Conclusion To get the best HGS value,it is better to perform the HGS measurement before dialysis session than after one,which suggest to perform measurement in dominant arm.Although the iAVF was allocated in dominant arm,the grip strength is obviously higher than non-dominant arm.The influence of dialysis interval on grip strength is not found in this study.

关 键 词：维持性血液透析 握力 动静脉内瘘 

分 类 号：R459.5[医药卫生—治疗学]