Huang Jianqiang, Zheng Peilan, Chen Xiaobin, Zheng Fan, He Beibei
Department of General Surgery, No. 900th Hospital of China People's Liberation Army Joint Logistics Support Force, Fuzhou, China.
Department of Nephrology, No. 900th Hospital of China People's Liberation Army Joint Logistics Support Force, Fuzhou, China.
Front Surg. 2023 Sep 11;10:1260979. doi: 10.3389/fsurg.2023.1260979. eCollection 2023.
Arteriovenous fistula (AVF) is the first choice of vascular access for hemodialysis treatment, and its surgical maturity rate is not high, and its postoperative complications (mostly stenosis) significantly shorten its life. At present, there are few studies on treatment methods to improve the maturity and survival of AVF. In this study, the effect of far infrared therapy (FIR) on the maturity and longevity of arteriovenous fistula in hemodialysis patients was discussed, and the protective mechanism of AVF induced by FIR therapy was explored, aiming at exploring a new treatment method.
The hemodialysis patients admitted to the 900th Hospital of the Chinese Joint Logistics Support Force of the People's Liberation Army from January 2021 to April 2023 were randomly divided into control group and intervention group, with 40 cases in each group. Among them, the control group was coated with mucopolysaccharide polysulfonate cream; Intervention group: The patients were treated with mucopolysaccharide polysulfonate cream and far infrared radiation at the same time. After 3 months' intervention, the arteriovenous fistula (vein diameter, mature time of arteriovenous fistula, blood flow controlled by pump during dialysis, blood flow of brachial artery during dialysis and the occurrence of complications of internal fistula (oozing, occlusion and infection) and the pain score (numerical rating scale, NRS) of the two groups were compared, and the curative effects were compared.
There was no significant difference in general data between the two groups ( > 0.05), which indicated that the study was comparable. After 3 months' intervention, the vein diameter, pump-controlled blood flow and brachial artery blood flow in the intervention group were significantly higher than those in the control group ( < 0.05). And the maturity time, NRS score and complication rate of arteriovenous fistula were significantly lower than those of the control group ( < 0.05). The primary patency rate of AVF in the intervention group was higher than that in the control group, and the overall patency rate between the two groups was statistically significant ( < 0.05).
As a promising new treatment method, far infrared therapy can effectively promote the maturity of AVF, increase venous diameter, pump controlled blood flow during dialysis, brachial artery blood flow during dialysis, and prolong the service life of AVF.
动静脉内瘘（AVF）是血液透析治疗血管通路的首选，但手术成熟率不高，术后并发症（主要是狭窄）显著缩短其使用寿命。目前，关于提高AVF成熟度和生存率的治疗方法研究较少。本研究探讨远红外疗法（FIR）对血液透析患者动静脉内瘘成熟度和使用寿命的影响，并探究FIR疗法诱导AVF的保护机制，旨在探索一种新的治疗方法。
选取2021年1月至2023年4月在中国人民解放军联勤保障部队第九〇〇医院收治的血液透析患者，随机分为对照组和干预组，每组40例。其中，对照组涂抹多磺酸粘多糖乳膏；干预组：患者同时接受多磺酸粘多糖乳膏和远红外照射治疗。干预3个月后，比较两组动静脉内瘘的静脉直径、动静脉内瘘成熟时间、透析时泵控血流量、透析时肱动脉血流量以及内瘘并发症（渗血、堵塞和感染）发生情况及疼痛评分（数字评分法，NRS），并比较疗效。
两组一般资料比较差异无统计学意义（>0.05），表明研究具有可比性。干预3个月后，干预组静脉直径、泵控血流量和肱动脉血流量均显著高于对照组（<0.05）。且动静脉内瘘成熟时间、NRS评分及并发症发生率均显著低于对照组（<0.05）。干预组AVF的初级通畅率高于对照组，两组总体通畅率差异有统计学意义（<0.05）。
远红外疗法作为一种有前景的新治疗方法，可有效促进AVF成熟，增加静脉直径、透析时泵控血流量、透析时肱动脉血流量，延长AVF使用寿命。
