摘要
目的研究术前功能锻练对动静脉内瘘成型术成功率及术后并发症的影响。方法将研究对象随机分为2组,分别为术前未行功能锻练组、术前功能锻练两个月组。收集研究对象动静脉内瘘术前年龄、性别、APACHE II评分、血清Cystatin C值,术前两个月及手术当天头静脉直径、血红蛋白、血小板、白蛋白、胆固醇等临床特征,手术后观察半年。观察指标包括内瘘手术是否成功、内瘘成熟时间、内瘘使用时间、肱动脉血流量、术后并发症,并分析比较各组间差别。结果未锻练组75例患者,术前锻练两个月组76例患者。手术总体成功率92.1%,其中术前锻练组手术成功率为94.7%,术前未锻练组为89.3%,两组间比较,差异有统计学意义(P=0.03);术前锻练组瘘口血流量比未锻练组平均多38.8 mL/min,内瘘成熟时间比未锻练组平均少4 d,差异有统计学意义。但是,在内瘘使用时间以及术后并发症的发生率比较中,两组差异无统计学意义。结论动静脉内瘘成形术前开始功能锻练,能够提高手术成功率,增加肱动脉血流量,但并不延长内瘘生存时间及减少并发症。
Objective To study the effect of preoperative functional exercises on the success rate of arteriovenostomy and postoperative complications.Methods The subjects were randomly divided into two groups:preoperative non-exercise group and preoperative exercise group.The age,sex,APACHE II score and serum Cystatin C value before operation,and cephalic vein diameter,hemoglobin,platelet,albumin,and cholesterol two months before operation and on the operation day were collected.And the subjects were observed for half a year after operation.The observation indicators included the success of internal fistula surgery,the maturation time of internal fistula,the use time of internal fistula,the blood flow of the brachial artery,and postoperative complications.And the differences between the groups were analyzed.Results There were 75 patients in the non-exercise group and 76 patients in the two-month exercise group.Overall success rate of surgery was 92.1%.The success rate of preoperative exercise group was 94.7%,and that of preoperative non-exercise group was 89.3%,with statistically significant difference between the two groups(P=0.03).The preoperative exercise group had a blood flow at the fistular orifice more than the non-exercise group by 38.8 ml/min.The average fistular maturation time in the exercise group was shorter than that in the non-exercise group by 4 days,with statistically significant difference between the two groups.However,there were no significant differences between the two groups in the comparison of the use time of internal fistula and the incidence of postoperative complications.Conclusions Functional exercises before arteriovenostomy can improve the success rate of surgery and increase the brachial blood flow,but it does not prolong the survival time of internal fistula or reduce the complication incidence.
作者
陈浩
刘娟
CHEN Hao;LIU Juan(Department of Nephrology,Chengdu Fifth People's Hospital,Chengdu 610000,China)
出处
《临床肾脏病杂志》
2020年第6期490-493,共4页
Journal Of Clinical Nephrology
关键词
动静脉内瘘
术前
功能锻炼
Arteriovenous internal fistula
Preoperative
Functional exercises
