运动疗法对维持性血液透析患者透析充分性和心理状态的影响  

Effects of exercise therapy on dialysis adequacy and psychological status of maintenance hemodialysis patients

作　　者：芦姗 温雯[1] 武向兰 李月红[1] Lu Shan;Wen Wen;Wu Xianglan;Li Yuehong(Department of Nephrology,Beijing Tsinghua Changgung Hospital,Beijing 100218,China)

机构地区：[1]清华大学附属北京清华长庚医院肾内科,北京100218

出　　处：《国际移植与血液净化杂志》2023年第1期18-21,共4页International Journal of Transplantation and Hemopurification

基　　金：北京清华长庚医院院级护理基金(22016C1008)。

摘　　要：目的分析探讨运动疗法对维持性血液透析患者透析充分性和心理状态的影响。方法选取2016年11月至2019年6月在清华大学附属北京清华长庚医院透析中心进行维持性血液透析的患者100例作为研究对象,将其随机分配到试验组和对照组。试验组在常规透析的基础上,每周3次在透析开始2 h内进行30 min床上踏车运动治疗,对照组患者未在常规透析的基础上予以运动干预。24周后,应用统计学方法对两组患者透析充分性、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及死亡率进行比较。结果完成试验患者共96例,包括男性58例,女性38例,年龄27~75岁,平均年龄(57±14)。其中试验组49例,对照组47例。在透析充分性方面,治疗前两组患者的尿素清除率(Kt/V)及尿素下降率URR差异无统计学意义(P>0.05),24周后Kt/V及URR的变化值和对照组也无明显差异(P>0.05);心理状态方面,24周后SAS得分和SDS得分降低程度显著高于对照组(P<0.05)。死亡率方面,试验组死亡率低于对照组(10%vs.19%),但两组间差异无统计学意义(P=0.21)。结论透析期间运动能够有效改善血液透析患者心理状态,提升生活质量。透析期间运动对生存的影响仍需进一步研究证实。Objective To explore the influence of exercise therapy on dialysis adequacy and psychological status quality of life in maintenance hemodialysis(MHD)patients.Methods A total of 100 patients who underwent MHD from November 2016 to June 2019 in our dialysis center were selected as the research subjects and randomly assigned to the experimental group and the control group.The experimental group were treated with 30-minute treadmill training three times a week within 2 hours of the start of dialysis on the basis of conventional dialysis.The patients in the control group were not given exercise intervention on the basis of conventional dialysis.After 24 weeks,the dialysis adequacy,self-rating anxiety scale(SAS),self-rating depression scale(SDS)and mortality were compared between the two groups using statistical method.P<0.05 was considered to be statistically significant.Results A total of 96 patients completed the trial,including 58 males and 38 females,aged from 27 to 75 years old,with the average age of(57±14).There were 49 cases in the experimental group and 47 cases in the control group.In terms of dialysis adequacy,there was no significant difference in Kt/V and URR between the two groups before treatment(P>0.05),nor was the change value of Kt/V and URR after 24 weeks significantly different from that in the control group(P>0.05).In terms of psychological state,the decreases of SAS and SDS scores after 24 weeks were significantly higher than those in the control group(P<0.05).As for mortality,the mortality rate in the experimental group was lower than that in the control group(10%vs.19%),but there was no significant difference between the two groups(P=0.21).Conclusions Exercise during dialysis can effectively improve the psychological status and quality of life of hemodialysis patients.The impact on survival needs to be confirmed by further studies.

关 键 词：维持性血液透析 运动疗法 透析充分性 心理状态 

分 类 号：R459.5[医药卫生—治疗学]