中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (12): 845-847.doi: 10.3969/j.issn.1671-4091.2014.12.011

• 血管通路 • 上一篇    下一篇

远红外线照射疗法对自体动静脉内瘘成熟的影响

肖光辉,王玉柱   

  1. 北京市海淀医院
  • 收稿日期:2014-04-02 出版日期:2014-12-12 发布日期:2014-12-12
  • 通讯作者: 王玉柱: wyz4417@126.com E-mail:xiaoguanghui1171@163.com

Effect of far infrared radiation on arteriovenous fistula maturation

  • Received:2014-04-02 Online:2014-12-12 Published:2014-12-12

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摘要： 【摘要】目的：评价远红外线照射疗法对终末期肾脏病患者新建立自体动静脉内瘘成熟的影响。方法：选择于我院就诊并行动静脉内瘘成形手术患者80名，随机进入对照组、治疗组。记录两组患者一般情况包括：性别、年龄、原发病、合并外周血管疾病、降压药物、抗血小板药物；由同一名术者选用相同的术式完成动静脉内瘘成形手术，术后治疗组给予远红外线照射，对照组不进行远红外线照射，两组患者于术后第1，2，3个月行彩色多普勒超声检查分别测定流出静脉内径及血流量，并于3个月时应用生理成熟内瘘穿刺进行血液透析，观察透析泵控血流量，出现穿刺损伤情况，评价两组患者内瘘生理成熟及临床成熟率。结果：共80名患者入组，其中治疗组39名，对照组38名患者完成观察，治疗组第2，3个月内瘘直径分别为0.45 ± 0.12，0.47 ± 0.11，高于对照组内径0.42 ± 0.11，0.43± 0.19（P=0.04，P=0.03）；治疗组第2，3个月时内瘘血流量分别为525.4±175．8，574.2±204.3，高于对照组487.8±187.4，523.2±238.2，（P=0.00，P=0.01）；治疗组3个月时生理成熟率高于对照组(97.4% 比 89.5%; P= 0.04)，临床成功率高于对照组（94.9% 比 84.2%; P= 0.04）。结论：远红外线照射可改善动静脉内瘘血流量，促进内瘘成熟。

关键词: 动静脉内瘘, 终末期肾脏病, 远红外线照射, 血液透析, 成熟。

Abstract: Objective To evaluate the effect of far infrared radiation on the maturation of newly created arteriovenous fistula (AVF) in patients with end stage renal disease. Methods We enrolled 80 patients who were randomly allocated to the intervention group (n =40) or control group (n=40). The operations of arteriovenous
fistula formation were done by one surgeon. Far infrared radiation was used for the intervention group, 40 minutes 3 times weekly, but not for the control group. Blood flow in AVF (Qa) and fistula diameter were measured by Doppler ultrasonography after the surgery for 1, 2 and 3 months. The physiologically maturated
fistula was then used for dialysis, and the pump blood flow and puncture injury were observed. Results Compared the patients in control group, patients in the intervention group had higher Qa values after far infrared radiation for 2 months (525.4 ± 175.8ml/min vs. 487.8 ± 187.4ml/min; P=0.000) and 3 months (574.2 ± 204.3ml/min vs. 23.2±238.2ml/min; P=0.010). In addition, they had larger AVF diameters after far infrared radiation for 2 months (0.45 ± 0.12mm vs. 0.42 ± 0.11mm; P=0.040) and 3 months (0.47 ± 0.11mm vs. 0.43 ± 0.19mm; P=0.030), more physiological maturation rate (97.4% vs. 84.2%; P = 0.040) at 3 months, and higher clinical success rate (94.9% vs. 84.2%; P= 0.010) within 3 months. Conclusions Far infrared radiation improves blood access flow, and promotes maturation of newly created AVFs in patients with end stage renal disease.

Key words: Arteriovenous fistula, End stage renal disease, Far infrared therapy, Hemodialysis, Maturation