Che Yusof Ruhana, Norhayati Mohd Noor, Azman Mohd Yacob
Faculty of Medicine, University of Cyberjaya, Cyberjaya, Selangor, Malaysia.
Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
J Chin Med Assoc. 2025 Jun 1;88(6):425-432. doi: 10.1097/JCMA.0000000000001236. Epub 2025 Apr 22.
Far-infrared (FIR) is one of the alternative therapies used to improve the performance of arteriovenous fistula (AVF) in hemodialysis patients. This review was done to pool the mean difference of vascular access flow and AVF diameter between the FIR and the control group. It also pooled the risk ratio of 1-year unassisted AVF patency, AVF occlusion, surgical intervention, and AVF malfunction between groups.
The studies were reviewed using a systematic review, meta-analysis, and a search of four databases. The risk of bias in non-randomized studies of interventions (ROBINS-I) and the Revised Cochrane risk-of-bias instrument for randomized trials (RoB-2) were used to assess the data quality. The meta-analysis was performed using the random-effects model by inverse variance to measure the mean difference for continuous data and the Mantel-Haenszel method for dichotomous data.
FIR therapy group had a significant difference in risk ratio in 1-year unassisted AVF patency (risk ratio: 1.23 [95% CI, 1.12-1.36]), AVF occlusion (risk ratio: 0.24 [95% CI, 0.08-0.68]), surgical intervention (risk ratio: 0.45 [95% CI, 0.23-0.86]), and AVF malfunction (risk ratio: 0.44 [95% CI, 0.30-0.62]) compared with the control group. However, for vascular access flow and AVF diameter, there was no difference between the groups (mean difference: 68.38 [95% CI, -3.84 to 140.61] and -0.07 [95% CI, -0.31 to 0.17], respectively).
The findings showed that the FIR therapy improved AVF performance. However, the limited number of studies primarily from Taiwanese may act differently from others.
远红外线（FIR）是用于改善血液透析患者动静脉内瘘（AVF）功能的替代疗法之一。本综述旨在汇总FIR组与对照组之间血管通路血流量和AVF直径的平均差异。同时也汇总了两组之间1年无辅助AVF通畅率、AVF闭塞、手术干预及AVF功能障碍的风险比。
通过系统评价、荟萃分析及检索四个数据库对研究进行回顾。采用干预性非随机研究的偏倚风险（ROBINS-I）和随机试验的修订版Cochrane偏倚风险工具（RoB-2）评估数据质量。荟萃分析采用随机效应模型，通过逆方差法测量连续数据的平均差异，采用Mantel-Haenszel法分析二分数据。
与对照组相比，FIR治疗组在1年无辅助AVF通畅率（风险比：1.23 [95%CI，1.12 - 1.36]）、AVF闭塞（风险比：0.24 [95%CI，0.08 - 0.68]）、手术干预（风险比：0.45 [95%CI，0.23 - 0.86]）及AVF功能障碍（风险比：0.44 [95%CI，0.30 - 0.62]）方面存在显著差异。然而，在血管通路血流量和AVF直径方面，两组之间无差异（平均差异分别为：68.38 [95%CI，-3.84至140.61]和-0.07 [95%CI，-0.31至0.17]）。
研究结果表明FIR治疗可改善AVF功能。然而，主要来自台湾地区的研究数量有限，其结果可能与其他研究不同。
