中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (10): 785-789.doi: 10.3969/j.issn.1671-4091.2023.10.015

• 血管通路 • 上一篇    下一篇

成年维持性血液透析患者动静脉内瘘上肢功能与健康个体比较的研究

王欣欣    孙 超    黎 爽   郑涵絮    顾国燕    宋晓朵    于海艳    尹咏梅    吴海虹   田 欣   管月红   尚云霄  赵 爽    黄富表   马迎春
  

  1. 100068 北京，首都医科大学康复医学院 中国康复研究中心北京博爱医院1肾内科 7作业治疗科
     100074 北京，2中国航天科工集团七三一医院肾内科
     100071 北京，3北京丰台医院血液透析室
     100079 北京，4北京市铁营医院血液透析室
     100076 北京，5北京市丰台区南苑医院血液透析室
     100069 北京，6北京市丰台右安门医院血液透析室
  • 收稿日期:2023-06-09 修回日期:2023-08-10 出版日期:2023-10-12 发布日期:2023-09-28
  • 通讯作者: 马迎春 E-mail:mych323@163.com
  • 基金资助:
    丰台区卫生健康系统科研项目(2020-98)

The comparison of upper limb function between maintenance hemodialysis patients with arteriovenous fistula or arteriovenous graft and healthy adults

WANG Xin-xin, SUN Chao, LI Shuang, ZHENG Han-xu, GU Guo-yan, SONG Xiao-duo, YU Hai-yan, YIN Yong-mei, WU Hai-hong, TIAN Xin, GUAN Yue-hong,  SHANG Yun-xiao, ZHAO Shuang, HUANG Fu-biao, MA Ying-chun   

  1. Department of Nephrology and 7Department of Occupational therapy, China Rehabilitation Research Center, Beijing BoAi Hospital, Capital Medical University Rehabilitation Medical College, Beijing 100068, China; 2Department of Nephrology, China Aerospace Science and Industry Corporation 731 Hospital, Beijing 100074, China; 3Hemodialysis Center, Beijing Fengtai Hospital, Beijing 100071, China; 4Hemodialysis Center, Fengtai Rehabilitation Hospital of Beijing Municipality (Tieying Hospital), Beijing 100079, China; 5Hemodialysis Center, Fengtai Nanyuan Hospital, Beijing 100076, China; 6Hemodialysis Center, Beijing Fengtai You’anmen Hospital, Beijing 100069, China
  • Received:2023-06-09 Revised:2023-08-10 Online:2023-10-12 Published:2023-09-28
  • Contact: 100068 北京，首都医科大学康复医学院 中国康复研究中心北京博爱医院1肾内科 E-mail:mych323@163.com

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摘要： 目的  比较维持性血液透析(maintenance hemodialysis,MHD)动静脉内瘘右利手患者与成年健康个体之间上肢功能的差异。 方法  横断面研究，纳入北京市6家血液透析中心的MHD动静脉内瘘且右利手患者，收集人口学资料、生化资料、握力及简易上肢功能检查(simple test for evaluating hand function,STEF)等上肢功能指标。MHD患者及成年健康个体上肢功能的比较采用t检验。 结果  共入组MHD患者90例，其中男性51例(56.7%)，年龄(59.63±10.60)岁，中位透析龄62.50(24.00,113.00)个月。将入组的MHD患者按照性别及年龄分组，与成年同年龄段健康人群的握力相比，35～40岁组[女性：(20.27±1.10)kg比28 kg,t=-9.968,P=0.064；男性：(25.85±8.38)kg比45 kg,t=-4.998,P=0.038]、41～50岁组[女性：(20.37±9.25)kg比28 kg,t=-1.844,P=0.139；男性：(27.59±10.43)kg比43 kg,t=-4.433,P=0.002]、51～60岁组[女性：(17.99±8.84)kg比26 kg,t=-2.717,P=0.026；男性：(25.64±9.04)kg比40 kg,t=-4.205,P=0.006]及61～70岁组[女性：(14.11±9.45)kg比23 kg,t=     -3.880,P=0.001；男性：(27.41±9.22)kg比36 kg,t=-4.837,P＜0.001]握力均存在下降。STEF各项目操作时间均高于中国健康人群。 结论  动静脉内瘘患者的握力及灵活性与健康人群相比均存在下降。

关键词: 维持性血液透析, 动静脉内瘘, 上肢功能

Abstract: Objective To compare the upper limb function between right-handed maintenance hemodialysis (MHD) patients with arteriovenous fistula (AVF) or AVF graft and healthy adults.  Method  The right-handed MHD patients with AVF or AVF graft for blood access from six hemodialysis centers in Beijing were enrolled in this cross-sectional study. Demographic and biochemical data, grip strength, and the operation time of Simple Test for Evaluating Hand Function (STEF) were collected. t-test was used to compare the upper limb function between MHD patients and healthy adults.  Results  A total of 90 MHD patients were enrolled, 51 patients were males, the mean age was 59.63±10.60 years, and the median dialysis vintage was 62.50 (24.00, 113.00) months. The MHD patients were divided into 8 groups by gender and age. The grip strength of MHD patients vs. healthy adults in the age groups were 35-40 years old (female: 20.27±1.10 vs. 28kg, t=-9.968, P=0.064; male: 25.85±8.38 vs. 45kg, t=-4.998, P=0.038), 41-50 years old (female: 20.37±9.25 vs. 28kg, t=-1.844, P=0.139; male: 27.59±10.43 vs. 43kg, t=-4.433, P=0.002), 51～60 years old (female: 17.99±8.84 vs. 26kg, t=-2.717, P=0.026; male: 25.64±9.04 vs. 40kg, t=-4.205, P=0.006), and 61～70 years old (female: 14.11±9.45 vs. 23kg, t=-3.880, P=0.001; male: 27.41±9.22 vs. 36kg, t=-4.837, P<0.001), indicating grip strength decreased in MHD patients as compared with healthy adults of the same age range. The operation time of each STEF items increased in MHD patients than in Chinese healthy adults (P<0.05).  Conclusions  The grip strength and flexibility were lower in MHD patients with AVF or AVF graft than in healthy people.

Key words: Maintenance hemodialysis, Arteriovenous fistula, Upper limb function

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