动静脉内瘘术后养成期的个性化束臂运动  

Individualized cuffed arm exercises during maturation period after arteriovenous fistula surgery

作　　者：马骏 张仲华 童辉 朱波 杨瑞[1] 王李胜 Ma Jun;Zhang Zhonghua;Tong Hui;Zhu Bo;Yang Rui;Wang Lisheng(Blood Purification Centre,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院血液净化中心,湖北武汉430030

出　　处：《护理学杂志》2021年第23期29-31,共3页Journal of Nursing Science

摘　　要：目的探讨个性化束臂运动对自体动静脉内瘘术后养成期内瘘成熟的影响。方法采用历史对照研究设计,以2018年11月至2019年5月的39例维持性血液透析患者为对照组,在动静脉内瘘术后按照常规方法进行功能锻炼;以2019年6~12月的39例患者为观察组,实施个性化束臂运动功能锻炼。比较两组术后不同时间内瘘的临床成熟及超声成熟情况。结果观察组术后4周、6周、8周内瘘肱动脉流量显著优于对照组,术后8周Ⅰ型狭窄发生率显著低于对照组,内瘘静脉最小穿刺内径、动脉最小穿刺内径、可穿刺血管长度显著长于对照组,内瘘成熟时间和内瘘成熟率显著短于和高于对照组(P<0.05,P<0.01)。结论个性化束臂运动功能锻炼能提高维持性血液透析患者动静脉内瘘养成期的成熟率,减少内瘘并发症发生。Objective To explore the effect of cuffed arm exercises on maturation after autologous arteriovenous fistula(AVF)surgery.Methods In the historical comparative study,39 hemodialysis patients recruited from November 2018 to May 2019,were included as the control group,and were instructed to perform routine functional exercises after AVF surgery;another 39 hemodialysis patients recruited from June to December 2019,were included as the intervention group,and were subjected to individualized cuffed arm exercises.The clinical and ultrasonic maturation indexes of AVF at different time points after the surgery were compared between the two groups.Results The brachial artery flow rate in the intervention group was significantly higher than that in the control group 4,6 and 8 weeks after AVF surgery.The incidence rate of type I stenosis in the intervention group was significantly lower than that in the control group 8 weeks after the surgery.The minimal luminal diameter of the fistula vein as well as of the fistula artery,and the length of fistula vein available for puncture in the intervention group were significantly longer than those in the control group.The time to and the rate of AVF maturation in the intervention group were significantly shorter and higher than those in the control group(P<0.05,P<0.01).Conclusion Individualized cuffed arm exercises could improve the maturation rate of AVF in patients on maintenance hemodialysis therapy,and reduce the complications of AVF.

关 键 词：维持性血液透析 动静脉内瘘 功能锻炼 束臂运动 成熟度 肱动脉流量 并发症 

分 类 号：R473.5[医药卫生—护理学]