不同时间远红外线照射治疗对维持性血液透析患者自体动静脉内瘘的保护效应.pdf

广东医学20l5年11月第356卷第22期 Guangdong Medical Journal Nov.2015,Vo.36,No.22
不同时间远红外线照射治疗对维持性血液透析
患者自体动静脉内瘘的保护效应“
沈燕',黄佑芳2,达静静,胡英,赵健秋,査艳?
贵州省人民医院肾内科(贵阳55000);2贵州医科大学第三附属医院(贵州都匀558000)
摘要】目的探讨不同时间远红外线照射对维持性血透患者自体动静脉內瘘的临床疗效。方法选取使
用自体动静脉内瘘的维持性血透1年以上的患者80例,分为20min组、40min组、60min组和对照组各20例,前
3组每次透祈时分别予以远红外线照射20、40和60min,每周3次,治疔6个月。对照组仅予规律透淅治疔。比较
4组的血流量变化及内瘘功能障碍发生率,并检测单次透析前后4组患者血高敏C反应蛋白( HSCRP)和白细胞介
素-8(L-8)浓度。结果与对照组相比,经过半年每周3次远红外线照射治疗后,20min、30min、40min组血流
量增值均明显高于对照组(P<0.05);40min及60min组血流量增值与20min组相比明显增加(P<0.05);40min
组与60min组间血流量增值差异无统计学意义(P>0.05)。20min、30min、40min组经半年远红外照射治疗后,血
HSCRP及L-8差值与对照组相比有下降趋势,但差异无统计学意义(P>0.05);40min及60min组较20muin组
下降明显,差异无统计学意义(P>0.05);40min组与60min组间差异无统计学意义(P>0.05)。结论选择每
周3次,每次40min的远红外照射的治疗方式对维持性透析患者自体动静脉内瘘可以达到最佳效果,值得临床推
广使用。
【关键词】远红外线;血流量;炎症反应;自体动静脉内瘘;血液透析
Protective effect of various durations of far-infrared radiation on autogenous arteriovenous fistula in mainte
nance hemodialysis patients. H Y,HUANG You-fang, DA ing-jing, HU Ying, ZHAO ian-u, ZA
Yan. Department of Nephrology, Guizhou Prouincial Peoples Hospital, Guiyang 550002, China
Corresponding author: ZHA Yan. E-mail: zhayan72@ 126 co
Abstract Objective To investigate the treatment effect of far infrared radiation on autogenous arteriovenous
tula in patients on maintenance hemodialysis. Methods Patients on auto enous arterovenous fistula for more than one
year were divided into the 20 min roup, 40 min rou, 60 min group and the ontrol group. Each group had 20 patients
The first 3 groups received far-infrared radiation for 20, 40 and 60 min at each time of dialysis, respectively, 3 times a
week, for 6 months. The control group only received regular dialysis treatment. Blood flow changes and the incidence of
fistula dysfunction were recorded. Levels of high-sensitivity C-reactive protein(HSCRP)and interleukin-8(il-8
were detected by ELISA. Results Compared with the control group, after far-infrared radiation therapy for six months
increases of blood flow in 20 min, 30 min, 40 min groups were si ificantly higher(P<0. 05). Blood flow increase in the
40 min and 60 min groups were higher than 20 min group(P<0.05). There was no statistically significant difference in
blood flow inerease between the 60 min and 40 min roup. After six months of far-infrared radiation therapy, serum
hs RP and I 8 decreased comared with the control group, but the differences among 20 min, 30 min, 40 min groups
were not statistically significant(P>0 05). Levels of serum HSCRP and IL-8 were lower in the 40 min group and 60
mir group than the 20 mir group, but similar between the 40 min group and the 60 min group. Conclusion Far-infra
red radiation session of 40 min, three times a week delivers the best treatment effects and worthy of clinical application on
autogenous arteriovenous fistula in maintenance hemodialysis patients
Key words far-infrared radiation; blood flow; inflammation autogenous arteriovenous fistula; hemodialysis
血管通路是维持性血液透析患者的生命线,好的用的通路类型,在我国占70%以上。 Feldman等报道
血管通路功能有助于提高透析充分性和患者的生活质在美国因血管通路障碍而住院的患者在血液透析住院
量。自体动静脉内痿(AVF)是长期血液透析患者最常患者中占20%,每年花费高达10亿美元2。如何做
好血管通路的护理工作,保护血液透析患者的生命线是
*国家自然科学基金资助项目(编号:81200539),国际科技合作计
划项目(编号:验科合外G字[2012]7045号),贵州省科技厅基金资一大挑战。远红外线是一种具有强热作用的放射线,波
助项目(编号:路科合S字2102号),贵州省卫计委科学技术长为5.6~10wm,已广泛用于卫生保健及食物保存
基金资助项目(编号: gzwkj2014-1-046, gzw