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目的观察握力锻炼对老年终末期肾病患者术后内瘘成熟的影响。方法行动静脉内瘘成形术的老年终末期肾病患者66例分为A组34例(术前至术后6个月持续握力锻炼,每日3次)和B组32例(术前至术后1个月围手术期握力锻炼,每日3次),比较两组上机后最大血流量和术后1、3、6个月超声下内瘘直径、血流量。结果两组上机后最大血流量相仿(P>0.05)。两组术后1、3、6个月超声下内瘘直径和血流量比较无统计学差异(P>0.05)。66例患者术后1、3、6个月超声下内瘘直径、血流量与K/DOQI指南推荐的最小值比较均有统计学差异(P<0.05)。结论围手术期每日3次的握力锻炼能满足内瘘成熟的需要。老年终末期肾病患者超声下内瘘直径和血流量小于K/DOQI指南推荐的最小值,我国老年患者的内瘘成熟标准可能异于国外。
Objective To observe the effect of grip training on the fistula maturation in elderly patients with end-stage renal disease. Methods Sixty-six patients with end-stage renal disease undergoing arteriovenous fistula surgery were divided into group A (n = 34), group A (n = 34), group B (n = 32) 1 month perioperative grip exercise, 3 times a day), the two groups were compared on the maximum blood flow and the 1,3,6 months after fistula diameter, blood flow. Results The maximum blood flow of the two groups was similar (P> 0.05). There was no significant difference in diameter and blood flow of fistula between the two groups at 1, 3 and 6 months after operation (P> 0.05). There was a significant difference in the diameter of fistula, the blood flow and the recommended minimum of K / DOQI guidelines in 66 patients at 1, 3 and 6 months after operation (P <0.05). Conclusion Perioperative three times daily grip exercises can meet the needs of fistula maturation. Fistula diameter and blood flow under ultrasound in elderly patients with end-stage renal disease is less than the minimum recommended by the K / DOQI guidelines. The standard of fistula maturation in elderly patients in our country may be different from abroad.