Abstract:

Objective　To investigate the effect of stepped grip strength exercise on patients with forearm hypervascularity of stage 4 chronic kidney disease (CKD). Methods　A total of 54 patients diagnosed with stage 4 CKD at 908th Hospital of Joint Logistic Support Force, Chinese People's Liberation Army from February 2018 to December 2021 were selected for the randomized controlled trial, and were divided into a control group and an experimental group by the random number table method, with 27 cases in each group. There were 17 males and 10 females in the control group; they were 32 to 74 (49.67±13.03) years old; their disease course was 5 - 21 (10.26±4.19) years. There were 15 males and 12 females in the experimental group; the were 28-71 (50.31±14.43) years old; their disease course was 6-23 (10.35±3.80) years. The control group did exercise with electronic grip apparatus, and the experimental group did stepped grip strength exercise with intelligent grip balls. The vascular diameters and blood flow velocities before exercise and 4 and 8 weeks after exercise and compliance were compared between the two groups. t and χ² tests used. Results　After 8 weeks' exercise, the internal diameter of cephalic vein in the control group was lower than that in the experimental group [(1.98±0.15) mm vs. (2.12±0.21) mm], with a statistical difference (t=4.63; P<0.05). After 4 and 8 weeks' exercise, the radial artery blood flow velocities in the control group were lower than those in the experimental group [(19.32±0.59) cm/s vs. (19.85±0.43) cm/s and (21.07±0.49) cm/s vs. (23.38±0.53) cm/s], with statistical differences (t=3.77 and 16.63; both P<0.05). After 8 weeks' exercise, the compliance in the experimental group was higher than that in the control group [85.19% (23/27) vs. 51.85% (14/27)], with a statistical difference (χ²=6.95; P<0.05). Conclusion　Stepped grip strength exercise for patients with forearm hypervascularity of stage 4 CKD can dilate their inner diameter of the cephalic vein, accelerate the radial artery blood flow, and improve their vascular conditions, with high exercise compliance.

Key words:

Chronic kidney disease, Grip strength exercise, Autologous arteriovenous fistula, Vascular conditions

摘要：

目的　探讨阶梯式握力锻炼对慢性肾脏病（CKD）4期前臂血管过细患者的影响。方法　随机对照研究，选择2018年2月至2021年12月在中国人民解放军联勤保障部队第九○八医院确诊CKD4期前臂血管内径过细患者共54例，按随机数字表法进行分组，对照组27例，男17例，女10例，年龄32～74（49.67±13.03）岁，病程5～21（10.26±4.19）年，采用电子握力器锻炼；试验组27例，男15例，女12例；年龄28～71（50.31±14.43）岁，病程6～23（10.35±3.80）年，采用握力球阶梯式锻炼。比较两组患者锻炼前、锻炼4周及8周后的血管内径及血流速度、依从性情况。统计学方法采用t检验、χ²检验。结果　锻炼8周后，对照组与试验组头静脉内径比较［（1.98±0.15）mm比（2.12±0.21）mm］，差异有统计学意义（t=4.63，P<0.05）；锻炼4周、8周后，对照组与试验组桡动脉血流速度比较［（19.32±0.59）cm/s比（19.85±0.43）cm/s、（21.07±0.49）cm/s比（23.38±0.53）cm/s］，差异均有统计学意义（t=3.77、16.63，均P<0.05）；锻炼8周后，试验组依从性优于对照组［85.19%（23/27）比51.85%（14/27）］，差异有统计学意义（χ²=6.95，P<0.05）。结论　阶梯式握力锻炼能扩张头静脉血管内径、加快桡动脉血流速度，改善CKD 4期前臂血管过细患者的血管条件，患者锻炼依从性高。

关键词:

慢性肾脏病, 握力锻炼, 自体动静脉内瘘, 血管条件