红外线治疗仪联合功能锻炼对AVF术后行血液透析患者动静脉内瘘成熟情况及血流量的影响

Effect of Infrared Therapeutic Instrument Combined with Functional Exercise on Maturation and Blood Flow of Arteriovenous Fistula in Hemodialysis Patients after AVF Surgery

目的探讨红外线治疗仪联合功能锻炼在自体动静脉内瘘(AVF)术后行血液透析患者中的应用价值.方法选择2019年10月—2022年8月该院收治的AVF术后行血液透析的80例患者为研究对象,按随机数字表法分为两组.对照组(n=40)采用功能锻炼,观察组(n=40)采用红外线治疗仪联合功能锻炼,两组均干预8周.对比分析两组动静脉内瘘成熟情况、内瘘血管质量、生活质量、内瘘并发症.结果观察组内瘘血管成熟率77.50%高于对照组的55.00%,内瘘血管成熟时间(3.01±0.21)周短于对照组的(3.79±0.28)周,组间差异有统计学意义(P<0.05).干预8周后,观察组血管距皮下距离(3.21±0.20)mm短于对照组的(3.60±0.24)mm,内瘘最大血流量(607.14±34.28)mL/min大于对照组的(543.98±31.05)mL/min,血管直径(5.24±0.19)mm长于对照组的(5.01±0.13)mm,血管内膜厚度(0.75±0.14)mm厚于对照组的(0.61±0.11)mm,组间差异有统计学意义(P<0.05).干预8周后,观察组生活质量综合评定问卷中心理功能评分(75.08±6.11)分、躯体功能评分(76.26±6.47)分、社会功能评分(73.01±5.02)分均高于对照组的(70.43±5.46)分、(71.92±5.38)分、(69.43±4.37)分,内瘘并发症发生率7.50%低于对照组的25.00%,组间差异有统计学意义(P<0.05).结论红外线治疗仪联合功能锻炼能够更好地促使AVF术后行血液透析患者动静脉内瘘成熟,增加内瘘血流量,增大血管直径与血管内膜厚度,降低内瘘并发症发生风险,提升生活质量,具有较高的临床应用价值.

Objective To explore the application value of infrared therapeutic instrument combined with functional exercise in hemodialysis patients after autologous arteriovenous fistula(AVF)surgery.Methods 80 hemodialysis patients after AVF surgery admitted to the hospital from October 2019 to August 2022 were selected as the research objects and divided into two groups according to random number table method.The control group(n=40)received functional exercise,and the observation group(n=40)received infrared therapeutic instrument combined with functional exercise.Both groups were intervened for 8 weeks.The maturity of arteriovenous fistula,quality of fistula vessels,quality of life and complications of fistula were compared between the two groups.Results The maturation rate of fistula vessels in the observation group was 77.50%,which was higher than 55.00%in the control group,the maturation time of fistula vessels was(3.01±0.21)weeks,which was shorter than(3.79±0.28)weeks in the control group,and the differences between the groups were statistically significant(P<0.05).After 8 weeks of intervention,the distance between blood vessels and the skin in the observation group was(3.21±0.20)mm,which was shorter than(3.60±0.24)mm in the control group,the maximum fistula blood flow was(607.14±34.28)mL/min,which was greater than(543.98±31.05)mL/min in the control group,the vascular diameter was(5.24±0.19)mm,which was longer than(5.01±0.13)mm of the control group,the thickness of vascular intima was(0.75±0.14)mm,which was thicker than(0.61±0.11)mm of the control group,and the differences between the groups were statistically significant(P<0.05).After 8 weeks of intervention,the scores of psychological function,physical function and social function of generic quality of life inventory-74 in observation group were(75.08±6.11)points,(76.26±6.47)points and(73.01±5.02)points,respectively,which were higher than(70.43±5.46)points,(71.92±5.38)points,(69.43±4.37)points in the control group,the incidence of fistula complications was 7.50%,which was lower than 25.00%in the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion The infrared therapeutic instrument combined with functional exercise can better promote the maturity of arteriovenous fistula in hemodialysis patients after AVF surgery,increase the blood flow of fistula,increase the diameter of blood vessels and thickness of vascular intima,reduce the risk of fistula complications,and improve the quality of life,which has high clinical application value.