基于镜像疗法下的康复方案在血透病人自体动静脉内瘘术后的应用研究

张娟; 汪丽; 刘中艳; 张蒙; 陈鑫

doi:10.13898/j.cnki.issn.1000-2200.2023.07.034

基于镜像疗法下的康复方案在血透病人自体动静脉内瘘术后的应用研究

Application value of the rehabilitation program based on mirror therapy in patients with hemodialysis after autologous arteriovenous fistula

摘要

摘要:
目的研究基于镜像疗法下的康复方案对血透病人自体动静脉内瘘术(AVF)后内瘘质量和自我管理能力的影响。
方法选取2019年12月至2022年9月的30例初次行AVF的病人作为观察组，回顾性选取2018年1月至2019年11月的30例初次行AVF的病人作为对照组，对照组采用康复锻炼常规指导方法，干预组采用基于镜像疗法下的康复锻炼方案为指导，干预时间为2个月，比较2组在干预前、干预后1个月和2个月的术侧上肢活动能力、内瘘血管直径、吻合口血流量、内瘘首次使用时间和自我管理能力的影响。
结果干预1个月和2个月后，观察组Fugl-Meyer运动评定量表(FMA-UE)得分、内瘘血管直径和吻合口血流量、AVF自我管理能力得分均高于对照组(P < 0.05)。2组病人干预前后各指标组内比较，差异均有统计学意义(P < 0.01)，随着干预时间推移，FMA-UE得分、内瘘血管直径和吻合口血流量、AVF自我管理能力得分均呈现增高趋势，干预1个月和2个月后，均高于干预前(P < 0.05~P < 0.01)，干预2个月后高于干预1个月后(P < 0.05~P < 0.01)。观察组内瘘成熟时间明显低于对照组(P < 0.01)。
结论基于镜像疗法的康复方案可以显著提升AVF病人术侧上肢的活动能力、增加血管直径和吻合口血流量，对促进内瘘成熟、提升自我管理能力有显著作用。

Abstract:
ObjectiveTo investigate the effects of rehabilitation program based on mirror therapy on the quality of internal fistula and self-management ability of hemodialysis patients after observation autogenous arteriovenous fistula(AVF).
MethodsThirty patients treated with AVF for the first time from December 2019 to September 2022 and 30 patients treated with AVF for the first time from January 2018 to November 2019 were divided into the observation group and control group, respectively.The control group and intervention group were guided by the routine rehabilitation exercise and rehabilitation exercise program based on mirror therapy for 2 months, respectively.The effects of upper limb mobility, internal fistula vessel diameter, anastomotic blood flow, first use time of internal fistula and self-management ability between two groups were compared before intervention, after 1 month and 2 months of intervention.
ResultsAfter 1 and 2 months of intervention, the scores of Fugl-Meyer assessment upper extremity scale (FMA-UE), internal fistula vessel diameter, anastomotic blood flow and AVF self-management ability in the observation group were higher than those in control group(P < 0.05).There were statistically significant in all indexes between two groups before and after intervention(P < 0.01).With the passage of intervention time, the scores of FMA-UE, internal fistula vessel diameter, anastomotic blood flow and AVF self-management ability showed an increasing trend, which after 1 month and 2 months of intervention were higher than those before intervention(P < 0.05 to P < 0.01), and which after 2 months of intervention was higher than those after 1 month of intervention(P < 0.05 to P < 0.01).The maturation time of fistula in the observation group was significantly lower than that that in control group(P < 0.01).
ConclusionsThe rehabilitation program based on mirror therapy can significantly improve the mobility of the upper limbs in the operative side, increase the blood vessel diameter and anastomotic blood flow, promote the maturity of internal fistula and improve the self-management ability of the patients with AVF.

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