血液透析期间运动干预应用于预防症状性低血压的效果研究

Effect of exercise intervention on the prevention of symptomatic hypotension during hemodialysis

目的研究血液透析期间运动干预应用于预防症状性低血压(IDH)的效果。方法选择江门市中心医院2019年6月—2020年6月长期透析且容易发生IDH的80例患者为研究对象,随机分为观察组与对照组,每组各40例。对照组接受常规透析干预措施,观察组接受常规透析干预联合运动干预疗法,比较2组患者干预前后的透析充分性指标(URR、Kt/V、β_(2)-MG)水平,发生IDH的例数、需要临床处理的例数、提前结束透析的例数、透析后直接起床的例数。结果2组患者干预前的URR、Kt/V、β_(2)-MG水平无统计学差异(P>0.05);干预后,2组患者URR、Kt/V水平均显著升高,β_(2)-MG水平均显著降低,且观察组改善幅度显著优于对照组(P<0.05)。观察组发生IDH的例数、需要临床处理的例数、提前结束透析的例数均显著低于对照组(P<0.05),而透析后直接起床例数则显著高于对照组(P<0.05)。结论在维持性血液透析期间应用运动干预可提高透析充分性,有助于预防IDH症状,具有较明显的效果。

Objective To study the application of exercise intervention in the prevention of symptomatic hypotension(IDH)during hemodialysis.Methods 80 patients with long-term dialysis in our hemodialysis center were selected who wer prone to IDH from June 2019 to June 2020 were selected.They were randomly divided into observation group and control group,with 40 cases in each group.The control group received routine dialysis intervention,and the observation group received routine dialysis combined with exercise intervention therapy.The level of dialysis adequacy index(URR,kt/V,β_(2)-MG)before and after intervention were compared between the two groups.the total number of cases of symptomatic hypotension,the number of cases requiring clinical treatment,the number of cases ending dialysis in advance and the number of cases getting up directly were compared between the two groups.Results There was no significant difference in the URR,kt/V andβ_(2)-mg level before intervention,(P>0.05).After intervention,the level of URR and kt/V of the two groups were significantly increased,the level ofβ_(2)-mg decreased significantly,and the improvement of URR,kt/V andβ_(2)-mg in observation group was significantly better than those in the control group(P<0.05).The total number of cases of IDH,the number of cases requiring clinical treatment and the number of cases ending dialysis in advance in the observation group were significantly lower than those in the control group(P<0.05),and the number of cases in the observation group who got up directly after dialysis was significantly higher than that in the control group(P<0.05).Conclusion Exercise intervention during maintenance hemodialysis can improve the adequacy of dialysis and help to prevent IDH symptoms.