透析间期计划性有氧-抗阻运动对患者营养状态及透析低血压的影响  

Effects of planned aerobic-resistance exercise on nutritional status and intra-dialytic hypotension of patients during dialysis

作　　者：朱礼阳 鲁美苏 王红林 赵迪[1] 马瑞霞 王晓阳[1] Zhu Liyang;Lu Meisu;Wang Honglin;Zhao Di;Ma Ruixia;Wang Xiaoyang(Kidney Disease Hospital,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Urology Surgery,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院肾脏病医院,郑州450000 [2]郑州大学第三附属医院泌尿外科,郑州450000

出　　处：《中华现代护理杂志》2020年第14期1894-1898,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨透析间期计划性有氧-抗阻运动对维持性血液透析(MHD)患者营养状态及透析低血压的影响。方法采用便利抽样法,选择2018年1-10月在郑州大学第一附属医院规律进行血液透析患者106例,根据随机数字表法分为对照组和观察组,各53例。对照组采用常规管理模式,观察组在对照组基础上进行透析间期计划性有氧-抗阻运动干预,为期3个月。比较两组患者血红蛋白(Hb)、血清前白蛋白(PA)、身体细胞量(BCM)、骨矿物质含量(BMC)、骨骼肌含量(SMC)、心肺功能和透析低血压发生率等指标的差异。结果干预3个月后,观察组患者Hb(99.77±6.29)g/L、PA(344.55±37.12)mg/L、BCM(31.42±3.15)kg、BMC(3.08±0.41)kg及SMC(27.85±2.51)kg,均较干预前提高,且高于对照组,差异有统计学意义(P<0.05)。干预3个月后,观察组最大摄氧量(14.93±2.82)ml/(kg·min)、左室射血分数(58.21±5.22)%,均高于对照组,差异有统计学意义(P<0.05)。干预期间,观察组和对照组透析低血压发生率分别为9.05%(187/2067)、19.45%(402/2067),观察组低于对照组,差异有统计学意义(χ^2=91.520,P<0.01)。结论透析间期计划性有氧-抗阻运动可以改善MHD患者营养状况,提高患者心肺功能及耐力,并减少透析低血压发生率,值得临床推广。Objective To explore the effects of planned aerobic-resistance exercise on nutritional status and intra-dialytic hypotension of maintenance hemodialysis(MHD)patients during dialysis.Methods From January 2018 to October 2018,we selected 106 hemodialysis patients in the First Affiliated Hospital of Zhengzhou University by convenience sampling.All of patients were divided into control group and observation group with method of the random number table,53 cases in each group.Control group carried out the routine management model.On the basis of that in control group,observation group implemented the planned aerobicresistance exercise during dialysis for three months.We compared the hemoglobin(Hb),serum prealbumin(PA),body cell mass(BCM),bone mineral content(BMC),skeletal muscle content(SMC),cardiopulmonary function and incidence of intra-dialytic hypotension of patients between two groups.Results Three months after intervention,the Hb,PA,BCM,BMC and SMC of patients in observation group were(99.77±6.29)g/L,(344.55±37.12)mg/L,(31.42±3.15)kg,(3.08±0.41)kg and(27.85±2.51)kg respectively higher than those in control group with statistical differences(P<0.05);the maximal oxygen uptake and left ventricular ejection fraction of observation group were(14.93±2.82)ml/(kg·min)and(58.21±5.22)%respectively higher than those in control group with statistical differences(P<0.05).During intervention,the incidence of intra-dialytic hypotension of observation group was 9.05%(187/2067)lower than that in control group[19.45%(402/2067)]with a statistical difference(χ^2=91.520,P<0.01).Conclusions Planned aerobic-resistance exercise during dialysis can improve the nutritional status,cardiopulmonary function and endurance of MHD patients,and reduce the incidence of intra-dialytic hypotension which is worthy of clinical promotion.

关 键 词：透析 有氧-抗阻运动 营养 透析低血压 

分 类 号：R473.5[医药卫生—护理学]