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量化握力训练在自体动静脉内瘘术后患者中的应用

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目的 制订量化握力训练方案并应用在自体动静脉内瘘术后患者中,评价其对自体动静脉内瘘成熟及初期使用的影响。方法 采用便利抽样法选取2021年9月至2022年11月南方医科大学深圳医院肾内科行头静脉-桡动脉吻合内瘘成形术的83例患者为研究对象,根据随访时间分为观察组(41例)和对照组(42例)。观察组在术后采用量化握力训练行内瘘侧肢体功能锻炼,对照组采用常规握球训练行内瘘侧肢体功能锻炼。于术后8周评价两组内瘘成熟率、内瘘自然血流量、头静脉内径、内瘘初期使用的泵前压及内瘘并发症发生率。结果 与对照组比较,观察组内瘘成熟率更高(97。6%vs。83。3%),头静脉内径[(5。24±0。66)mm vs。(4。63±0。59)mm]、内瘘自然血流量[(1215。38±562。99)mL/min vs。(955。75±341。94)mL/min]更大,内瘘初期使用泵前压[(119。20±19。83)mmHg vs。(135。74±17。07)mmHg]更低,差异有统计学意义(P<0。05)。结论 量化握力训练可提高患者内瘘术后成熟率,且对内瘘初期使用有益。
Application of quantitative grip strength training in postoperative patients with autogenous arteriovenous internal fistula
Objective To formulate the quantitative grip strength training program for application in the postoperative patients with autogenous arteriovenous internal fistula,and to evaluate its effect on the mat-uration and initial use of autogenous arteriovenous internal fistula.Methods A total of 98 patients with ce-phalic venous radial arterial anastomosis internal fistula formation surgery in Shenzhen Hospital of Southern Medical University from September 2021 to November 2022 were selected as the study subjects by the conven-ience sampling method.According to the follow-up time,they were divided into the observation group (n=41) and control group (n=42).The observation group adopted the quantitative grip strength training for function-al exercise of the limb on the side of internal fistula,while the control group adopted the conventional grip training for functional exercise of the limb on the side of internal fistula.In postoperative 8 weeks,the matura-tion rate of internal fistula,natural blood flow amount of internal fistula,internal diameter of cephalic vein,pre-pump pressure used in the initial stage of internal fistula and the incidence rate of internal fistula complica-tions were evaluated in the two groups.Results Compared with the control group,the maturation rate of in-ternal fistula in the observation group was higher (97.6% vs. 83.3%).The inner diameter of cephalic vein and natural blood flow amount of internal fistula in the observation group were larger than those in the control group[(5.24±0.66)mm vs. (4.63±0.59)mm;(1215.38±562.99)mL/min vs. (955.75±341.94)mL/min],the pre-pump pressure used at the initial stage of internal fistula in the observation group was lower than that in the control group[(119.20±19.83)mmHg vs. (135.74±17.07)mmHg],and the differences were statistically significant (P<0.05).Conclusion The quantitative grip strength training could increase the postoperative maturity rate of patients's internal fistula,and is beneficial to the use in the initial stage of internal fistula.

autologous arteriovenous internal fistulatrainingcomplicationsmaturepre-pump pressure

李思怡、路遥、刘晶、张美斌、龚慧金、李明妍、欧阳艳琼

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武汉大学护理学院,武汉 430000

南方医科大学深圳医院血液透析中心,广东深圳 518100

自体动静脉内瘘 训练 并发症 成熟 泵前压

广东省深圳市宝安区基础研究(医疗卫生类)项目

2021JD372

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(11)