中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (10): 790-794.doi: 10.3969/j.issn.1671-4091.2024.10.013

• 护理研究 • 上一篇    下一篇

血液透析中有氧运动干预对患者生存状态及生活质量影响的Meta分析

郭状状  虞 梁   杨家慧   李玲玲  徐 玮   朱亚梅   

  1. 210029 南京，1江苏省人民医院南京医科大学第一附属医院血液净化中心
    211112 南京，2南京医科大学附属第一临床医学院
  • 收稿日期:2024-02-19 修回日期:2024-07-24 出版日期:2024-10-12 发布日期:2024-10-12
  • 通讯作者: 朱亚梅 E-mail:zymsry888@163.com
  • 基金资助:
    210029 南京，1江苏省人民医院南京医科大学第一附属医院血液净化中心
    211112 南京，2南京医科大学附属第一临床医学院

Effects of intradialytic aerobic exercise on survival status and quality of life in patients undergoing maintenance hemodialysis: a meta-analysis

GUO Zhuang-zhuang,  YU Liang,  YANG Jia-hui,  LI Ling-ling, XU Wei, ZHU Ya-mei   

  1. Center of Blood Purification, Jiangsu Province Hospital, Nanjing 210029, China; 2The First Affiliated Clinical Medical College of Nanjing Medical University, Nanjing 211112, China 
  • Received:2024-02-19 Revised:2024-07-24 Online:2024-10-12 Published:2024-10-12
  • Contact: 210029 南京，1江苏省人民医院南京医科大学第一附属医院血液净化中心 E-mail:zymsry888@163.com
  • Supported by:
    Center of Blood Purification, Jiangsu Province Hospital, Nanjing 210029, China; 2The First Affiliated Clinical Medical College of Nanjing Medical University, Nanjing 211112, China

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摘要： 目的  评估透析中有氧运动干预对维持性血液透析患者生存状态及生活质量的影响。 方法  系统检索PubMed、EMBASE、MEDLINE、Google Scholar、Cochrane Library、万方、维普及中国知网数据库中涉及透析中有氧运动干预的随机对照研究。时限定至2023年10月1日。使用Jadad量表进行质量评估，Stata 12.0软件进行Meta分析。 结果  最终纳入文献30篇。Meta分析结果显示干预组透析性低血压事件(OR=0.410，95% CI：0.181～0.930，P=0.033)、国际不宁腿综合症评分(WMD=-4.661， 95% CI：-5.331～-3.992，P＜0.001)、60s起坐次数(WMD=3.075，95% CI：1.367～4.783，P＜0.001)、5次起坐时间(WMD=-1.447，95% CI：-2.716～-0.237，P=0.020)、10次起坐时间(WMD=-4.630，95% CI：-7.41～-1.849，P=0.001)、6 min步行测试(WMD=44.903，95% CI：32.651～57.155，P＜0.001)、握力(WMD=6.207，95% CI：3.368～9.046，P＜0.001)、单室尿素清除指数(WMD=0.095，95% CI：0.051～0.140，P＜0.001)、尿素减少率(WMD=4.820，95% CI：3.565～6.075，P＜0.001)及生活质量评分较常规护理组改善。此外，亚组分析提示长期干预组透析充分性(WMD=0.095，95% CI：0.051～0.140，P＜0.001)、60s起坐次数(WMD=3.075，95% CI：1.367～4.783，P＜0.001)及6 min步行距离(WMD=44.903，95% CI：32.651～57.155，P＜0.001)较短期干预组改善效果相对更好。 结论  透析中有氧运动干预有效改善患者生存状态及生活质量，且长期干预效果更佳。

关键词: 血液透析, 有氧运动

Abstract: Objective  To assess the impact of intradialytic aerobic exercise on survival status and quality of life among maintenance hemodialysis patients. Methods  A systematic literature search for randomized controlled trials on intradialytic aerobic exercise was performed in PubMed, EMBASE, MEDLINE, Google Scholar, Cochrane Library, Wanfang, VIP and China National Knowledge Infrastructure (CNKI) from inception until October first, 2023. The Jadad scale was used to perform quality assessment. The Stata 12.0 software was used to perform meta-analysis.  Results  A total of 30 studies were included. Meta-analysis showed that intradialytic hypotension (OR=0.410, 95% CI:0.181～0.930, P=0.033), restless legs syndrome (WMD=
-4.661, 95% CI:-5.331～-3.992, P＜0.001), 60-second sit-to-stand test (WMD=3.075, 95% CI:1.367～4.783, P＜0.001), 5-repetition sit-to-stand test (WMD=-1.447, 95% CI:-2.716～-0.237, P=0.020), 10-repetition sit-to-stand test (WMD=-4.630, 95% CI:-7.41～-1.849, P=0.001), 6-minute walk distance (WMD=44.903, 95% CI:32.651～57.155, P＜0.001), hand grip strength (WMD=6.207, 95% CI:3.368～9.046, P＜0.001), single pool clearance index (WMD=0.095, 95% CI:0.051～0.140, P＜0.001), urea reduction ratio (WMD=4.820, 95% CI:3.565～6.075, P＜0.001) and life quality scores were improved in the patients with intradialytic aerobic exercise group as compared to the patients using conventional care group. Subgroup analysis suggested that the dialysis adequacy, 60-second sit-to-stand test and 6-minute walking distance improved more in the long-term intervention group than in the short-term intervention group.  Conclusions  Intradialytic aerobic exercise can improve survival status and quality of life in hemodialysis patients, and the effectiveness becomes better in the patients with longer term of the intervention.

Key words: Renal dialysis, Aerobic exercise

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