Wongmahisorn Yuthapong, Kanchanasuttirak Pong, Stapanavatr Waigoon, Fusakul Yupadee
Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Ann Vasc Dis. 2025;18(1). doi: 10.3400/avd.oa.24-00136. Epub 2025 Apr 17.
We primarily aimed to compare the acute effects of hand-squeezing exercises, with and without tourniquet-like compression, on vessel size 5 minutes post-exercise in patients after arteriovenous fistula (AVF) creation. The secondary aim was to assess differences in AVF blood flow rates between the 2 interventions. A randomized study was conducted at a university hospital in Bangkok, Thailand, from October 2018 to September 2023. Seventy-eight participants, 2 weeks post-first-time autogenous AVF creation, were randomized into 2 groups: a non-compression group (n = 39) performing 5 minutes of hand-squeezing exercises and a compression group (n = 39) performing the same exercises with tourniquet-like compression. Ultrasound measured venous diameter and blood flow rates pre- and post-exercise. Both groups showed increased venous diameter, but the difference between the groups was not statistically significant (mean difference: 0.18 mm with compression vs. 0.12 mm without; P = 0.489). Blood flow rates increased significantly in the compression group compared to the non-compression group (mean difference: 171.49 vs. 24.44 mL/min; P = 0.002). Hand-squeezing exercises with tourniquet-like compression significantly improved AVF blood flow rates acutely, supporting its potential to enhance AVF maturation. Further research is needed to assess long-term benefits.
我们的主要目的是比较在动静脉内瘘(AVF)建立后的患者中,进行手部挤压练习(有或没有类似止血带的压迫)对运动后5分钟血管大小的急性影响。次要目的是评估这两种干预措施之间AVF血流速率的差异。2018年10月至2023年9月在泰国曼谷的一家大学医院进行了一项随机研究。78名首次自体AVF建立后2周的参与者被随机分为两组:非压迫组(n = 39)进行5分钟的手部挤压练习,压迫组(n = 39)进行相同的练习并施加类似止血带的压迫。超声测量运动前后的静脉直径和血流速率。两组静脉直径均增加,但组间差异无统计学意义(平均差异:压迫组为0.18 mm,非压迫组为0.12 mm;P = 0.489)。与非压迫组相比,压迫组的血流速率显著增加(平均差异:171.49 vs. 24.44 mL/min;P = 0.002)。类似止血带压迫的手部挤压练习可急性显著提高AVF血流速率,支持其增强AVF成熟的潜力。需要进一步研究以评估长期益处。