摘要目的 观察早期实施运动疗法的护理干预对维持性血液透析患者运动能力的影响,为探索适合血液透析患者的运动疗法提供依据.方法 入选60例维持性血液透析患者,采用自身前后对照研究,针对患者运动能力设计个体化的运动方案.观察患者在运动前、运动3个月和运动6个月后心率、平均动脉压、下肢肌围、运动能力评分、睡眠状况等指标的变化情况.结果 60例患者运动3个月后平均动脉压下降,与运动前比较差异有统计学意义[(76±21)mm Hg比(86±19)mm Hg,t=0.763,P<0.05];下肢肌围上升,与运动前比较差异有统计学意义[(29.65±11)cm比(28.55±12)cm,t=0.841,P<0.05];运动能力评分升高,与运动前比较差异有统计学意义[(11±1.5)分比(8±2.5)分,t=0.694,P<0.05];患者睡眠状况改善明显,与运动前比较差异有统计学意义(睡眠差的比较:2比6,χ2=0.27,P<0.05).运动6个月后患者平均动脉压、下肢肌围、运动能力评分、睡眠状况与运动前比较差异均有统计学意义(P<0.01或P<0.05);运动3个月、运动6个月患者心率与运动前比较差异均无统计学意义(P>.05).结论 低强度长时间运动模式能有效改善维持性血液透析患者的身体状况.

abstractsObjective Decreased exercise capacity in the maintenance hemodialysis (MHD) patients is a key factor affecting hemodialysis patients' life quality and contributes to complications and mortality. The purpose of the study was to investigate the effect of nursing care based on low-intensity prolonged aerobic exercise in the exercise capacity of MHD patients. Methods A total of sixty MHD patients (male 32 and female 28) were included in this study. All underwent a 6-month individualized mild aerobic exercise program. Self-control was adopted in this experiment. Heart rate (HR), the mean arterial pressure (MAP), lower limb muscle circumference, exercise capacity score, sleep status were collected at 3 different occasions during the 6-month periods (before, and 3 months, and 6 months after exercise).Results MAP was significantly decreased after 3-months,compared with before exercise was statistically significant [(76±21)mm Hg vs (86±19)mm Hg,t=0.763,P<0.05];lower limb muscle circumference increased [(29.65±11)cm vs (28.55±12)cm,t=0.841,P<0.05];exercise capacity scores were significantly improved [(11±1.5)scores vs (8±2.5)scores,t=0.694,P<0.05];sleep quality in patients improved significantly (poor sleep quality:2 vs 6,χ2=0.27,P<0.05). MAP,limb muscle circumference,exercise capacity scores,sleep quality compared with before exercise,there were statistically significant(P<0.01 or P<0.05);There were no differences in HR before and after exercise (P>0.05).Conclusions Low-intensity prolonged aerobic exercise may improve exercise capacity in maintenance hemodialysis patients.