中国血液净化 ›› 2023, Vol. 22 ›› Issue (06): 472-476.doi: 10.3969/j.issn.1671-4091.2023.06.016

• 护理研究 • 上一篇    下一篇

维持性血液透析患者运动康复的循证实践

张 旋   郭月月   周扣香   陈婷婷   薄祥敏   刘胜凤   

  1. 210029 南京,1江苏省中医院肾内科
  • 收稿日期:2022-10-31 修回日期:2023-03-14 出版日期:2023-06-12 发布日期:2023-06-12
  • 通讯作者: 张旋 E-mail:zhangxuan0417@163.com
  • 基金资助:
    江苏省名老中医药专家孙伟传承工作室项目(苏中医教科[2019]10号);江苏省中医药管理局科技项目(JD2019SZ06)

Evidence-based practice of exercise rehabilitation in maintenance hemodialysis patients

ZHAN Xuan, GUO Yue-yue, ZHOU Kou-xiang, CHEN Ting-ting, BO Xiang-min, LIU Sheng-feng   

  1. Department of Nephrology, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, China
  • Received:2022-10-31 Revised:2023-03-14 Online:2023-06-12 Published:2023-06-12
  • Contact: 210029 南京,1江苏省中医院肾内科 E-mail:zhangxuan0417@163.com

摘要: 目的 基于维持性血液透析患者运动康复的证据,实施循证实践,并验证其在改善维持性血液透析患者机体功能、运动耐力和生活质量中的作用。 方法 基于证据的持续质量改善模型为研究框架,于2021年1月~12月通过证据获取、现状审查、证据引入,构建维持性血液透析患者运动康复的循证方案;选取2022年1月~3月在江苏省中医院肾内科住院且维持性血液透析患者80例,随机分为试验组和对照组,各40例,比较运动干预后2组患者肌肉质量、肌肉力量、6分钟步行试验、生活质量指标的差异,同时比较循证实践前后医务人员对运动康复证据的知晓率变化。 结果 最终纳入9条证据,共7条审查指标。运动干预后,试验组较对照组患者肌肉质量提高(t=-3.302,P<0.01)、肌肉力量提升(t=-2.825,P<0.001)、6分钟步行增加(t=-5.529,P<0.001);试验组健康调查简表各维度总分均较对照组提高 (P<0.05);循证实践前后医护人员运动康复证据的知晓率提高40.74%,差异有统计学意义(P<0.001)。 结论 基于证据的运动康复循证实践能够改善维持性血液透析患者机体功能、运动耐力,提高生活质量。

关键词: 血液透析, 运动康复, 循证护理

Abstract: Objective   To implement evidence-based practice based on the evidences from exercise rehabilitation in maintenance hemodialysis (MHD) patients, and to validate the role of exercise rehabilitation in improving physical function, exercise tolerance, and quality of life in MHD patients.  Methods  The evidence-based continuous quality improvement model was used as the research framework, and an evidence-based program for exercise rehabilitation in MHD patients was conducted from January to December 2021 through evidence acquisition, status review and evidence introduction. A total of 80 MHD patients hospitalized in the Department of Nephrology, Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to March 2022 were then recruited and randomly divided into experimental group (n=40) and control group (n=40). After the exercise intervention, the muscle mass, muscle strength, 6-minute walking test, and quality of life were compared between the two groups. The awareness of sport rehabilitation evidence in medical staff was also compared before and after the evidence-based practice.  Results   Nine pieces of evidences were finally included, with a total of seven reviewed indicators. After exercise intervention, muscle mass (t=-3.302, P<0.01), muscle strength (t=-2.825, P<0.001), and 6-minute walking (t=-5.529, P<0.001) increased more in experimental group than in control group. The total scores of each dimension in the Health Survey Short Form increased more in experimental group than in control group (P<0.05). The awareness rate of sport rehabilitation evidence among medical staff increased by 40.74% before and after evidence-based practice, which has a statistical significance (P<0.001).  Conclusion  The evidence-based exercise rehabilitation practice can improve the body function, exercise endurance and quality of life in MHD patients.

Key words: Hemodialysis, Sport rehabilitation, Evidence-based nursing

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