远红外线治疗老年血液透析患者动静脉瘘管的效果观察

Effects of far infrared ray on arteriovenous fistula in elderly patients with hemodialysis

目的 探讨远红外线疗法对老年血液透析患者瘘管血流量和并发症的影响.方法 将67例血液透析老年患者（≥65岁）随机分为治疗组33例和对照组34例.对照组患者血液透析结束后瘘管常规包扎和护理;治疗组在此基础上,远红外线热疗40 min,每周2~3次,持续6个月.疗效判断指标包括超声检测瘘管血流量和瘘管并发症等.结果 治疗组患者6个月时超声检测瘘管血流量为（466.85±163.56）ml/min,明显高于对照组的（380.6±186.83）ml/min,差异有统计学意义（t=4.147,P=0.046）.6个月内瘘管并发症的总发生率为22.39%（15/67）,依次为瘘管狭窄、瘘管血栓形成和假性动脉瘤;治疗组并发症发生率为13.12%,明显低于对照组的32.35%,差异有统计学意义（P〈;0.05）.治疗组中未见皮肤灼伤等不良事件.结论 远红外线热疗可以显著改善老年血液透析患者瘘管的血流量,同时减少瘘管并发症.

Objective To explore the effect of far infrared ray on blood flow and complications of fistula in elderly patients with hemodialysis.Methods A total of 67 elderly patients （≥65 years old） with hemodialysis were randomly divided into treatment group （n=33,binding up fistula and nursing routinely after finishing hemodialysis） and control group （n=34,binding up fistula and nursing routinely after finishing hemodialysis,heat treatment of far infrared ray for 40 minutes,2-3 times per week,lasting six months）. The indicators of therapeutic evaluation included blood flow of fistula detected by ultrasound and complications of fistula and so on.Results The blood flow of fistula detected by ultrasound of patients in treatment group was （466.85±163.56） ml/min at six months which was higher than that in control group [（380.68±186.83） ml/min] with a significant difference（t=4.147,P=0.046）. The total incidence of complications of fistula was 22.39% （15/67） within six months,followed by fistula stenosis,thrombopoiesis of stenosis,false aneurysm. The incidence of complications in treatment group was 13.12% which was statistically lower than that in control group （32.35%） （P〈;0.05）. There was no adverse event including skin burn and so on in treatment group.Conclusions The far infrared ray can obviously improve the blood flow of fistula and reduce the complications of fistula in elderly patients with hemodialysis.