卧式脚踏车运动在预防患者血液透析中低血压的应用研究

Research on application of in-bed cycling on preventing patients’hypotension during hemodialysis

目的观察卧式脚踏车运动对降低患者血液透析中低血压发生率的影响。方法选取97例维持性血液透析患者作为研究对象,采用随机数字表分为对照组49例及观察组48例,对照组给予常规维持性血液透析护理,观察组在此基础上进行透析中卧式脚踏车运动。比较两组患者干预前3个月及干预3个月期间透析中低血压的发生率,干预3个月后好转率。结果干预后,观察组透析中低血压发生率为15.1%低于对照组的25.4%,而好转率为50.0%高于对照组的24.5%。观察组透析中低血压好转的概率是对照组的3.08倍(95%CI:1.30~7.31);将年龄、性别因素进行校正后,与对照组相比,观察组透析中低血压好转的概率是对照组的2.93倍(95%CI:1.22~7.03);将原发病、透析龄、体质指数、尿素清除指数、超滤率、白蛋白6个因素进行校正后,与对照组相比,观察组透析中低血压好转的概率是对照组的3.44倍(95%CI:1.37~8.61)。结论卧式脚踏车运动能有效改善维持性血液透析患者透析中低血压的发生情况。

Objective To observe the effect of in-bed cycling on reducing incidence of patients’hypotension during hemodialysis.Method Choose 97 maintenance hemodialysis patients and divide them into observation group(n=48)and control group(n=49)by random number table.Patients in control group receive routine nursing care on maintenance hemodialysis.Patients in observation group receive in-bed cycling exercise based on routine care.Compare the incidence of hypotension during hemodialysis between two groups 3 months before and during intervention.Result Incidence of hypotension during hemodialysis after intervention is 15.1%in observation group,which is lower than 25.4%in control group.Recovery rate is 50.0%in observation group,which is higher than 24.5%in control group.The incidence of recovery from hypotension during hemodialysis is 3.08 times in observation group compare to control group(95%CI:1.30~7.31);The incidence of recovery is 2.93 times in observation group compare to control group after correction on age and gender(95%CI:1.22~7.03);The incidence of recovery is 3.44 times in observation group compare to control group after correction on 6 factors of primary diseases,dialysis age,BMI,KT/V,ultrafiltration rate and albumin(95%CI:1.37~8.61).Conclusion In-bed cycling can relieve maintenance hemodialysis patients’hypotension during hemodialysis.