壳聚糖和远红外线联合治疗在改善自体动静脉瘘血管通路流量中作用.docVIP

壳聚糖和远红外线联合治疗在改善自体动静脉瘘血管通路流量中作用 　　[摘要] 目的 探?壳聚糖联合远红外线治疗在改善自体动静脉瘘血管流量中的效果。 方法 选取我院血液透析室在2015年1月～2016年2月收治的采用自体动静脉瘘维持血液透析的尿毒症患者66例，按照随机数字表法分为远红外线组、壳聚糖与远红外线联合治疗组、对照组，各22例；远红外线组在透析开始后对动静脉瘘处进行照射，每次40min；联合治疗组远红外线照射前在动静脉瘘处给予壳聚糖喷雾剂喷洒；对照组仅给予常规透析护理。采用彩色多普勒超声分别于研究开始时、研究后6个月、研究后1年检测自体动静脉瘘口的血流量，记录为Qa0、Qa1、Qa2；比较三组患者不同时间点动静脉瘘口血流量变化，同时观察三组患者动静脉瘘出现并发症情况。 结果 研究1年后，远红外线组与联合治疗组患者Qa1、Qa2显著高于Qa0，差异具有统计学意义（P0.05）；组间比较，联合治疗组Δ（Qa1- Qa0）、Δ（Qa2- Qa0）显著高于对照组与远红外线组（P0.05）；远红外线组Δ（Qa1- Qa0）、Δ（Qa2- Qa0）显著高于对照组（P0.05）；并发症方面，联合治疗组与远红外线组并发症发生率明显低于对照组（9.09%vs13.63%vs27.27%），差异具有统计学意义（P0.05）。 结论 采用自体动静脉瘘维持血液透析的尿毒症患者应用壳聚糖联合远红外线能够有效提高自体动静脉瘘血管流量，降低动静脉瘘并发症，值得临床护理推广应用。 　　[关键词] 远红外线；自体动静脉瘘；血管流量；壳聚糖 　　[中图分类号] R473.5 [文献标识码] A [文章编号] 2095-0616（2017）15-171-04 　　[Abstract] Objective To explore the effect of combined treatment of chitosan and far-infrared ray in improving the blood flow of arteriovenous fistula. Methods 66 patients with uremia underwent hemodialysis with autologous arteriovenous fistula in Hemodialysis room of our hospital from January 2015 to February 2016 were slelected and divided into far infrared group， chitosan and far infrared combined treatment group and control group with 22 cases in each according to random digigtal table method. Patients in far infrared group were treated with radiation at the arteriovenous fistula at the beginning of dialysis， each time 40min. Patients in chitosan and far infrared combined treatment group were treated with chitosan sprays at the arteriovenous fistula before irradiation with far infrared rays， and patients in control group were treated with routine dialysis care. At the beginning of the study， 6 months after the study and 1 years after the study， color Doppler ultrasonography was used to measure the mouth of an arteriovenous fistula as Qa0， Qa1 and Qa2， to compared blood flow of arteriovenous fistula at different time points in three groups and oberve the complications of arteriovenous fistula in the three groups. Results After 1 years， the Qa1 a