CAJ | 학술논문

目的：探讨不同时间远红外线照射对维持性血透患者自体动静脉内瘘的临床疗效。方法选取使用自体动静脉内瘘的维持性血透1年以上的患者80例，分为20 min组、40 min组、60 min组和对照组各20例，前3组每次透析时分别予以远红外线照射20、40和60 min，每周3次，治疗6个月。对照组仅予规律透析治疗。比较4组的血流量变化及内瘘功能障碍发生率，并检测单次透析前后4组患者血高敏C反应蛋白（ hsCRP）和白细胞介素－8（IL－8）浓度。结果与对照组相比，经过半年每周3次远红外线照射治疗后，20 min、30 min、40 min组血流量增值均明显高于对照组（ P＜0.05）；40 min及60 min组血流量增值与20 min组相比明显增加（ P＜0.05）；40 min组与60 min组间血流量增值差异无统计学意义（ P＞0.05）。20 min、30 min、40 min组经半年远红外照射治疗后，血hsCRP及IL－8差值与对照组相比有下降趋势，但差异无统计学意义（ P＞0.05）；40 min及60 min组较20 min组下降明显，差异无统计学意义（P＞0.05）；40 min组与60 min组间差异无统计学意义（P＞0.05）。结论选择每周3次，每次40 min的远红外照射的治疗方式对维持性透析患者自体动静脉内瘘可以达到最佳效果，值得临床推广使用。
목적：탐토불동시간원홍외선조사대유지성혈투환자자체동정맥내루적림상료효。방법선취사용자체동정맥내루적유지성혈투1년이상적환자80례，분위20 min조、40 min조、60 min조화대조조각20례，전3조매차투석시분별여이원홍외선조사20、40화60 min，매주3차，치료6개월。대조조부여규률투석치료。비교4조적혈류량변화급내루공능장애발생솔，병검측단차투석전후4조환자혈고민C반응단백（ hsCRP）화백세포개소－8（IL－8）농도。결과여대조조상비，경과반년매주3차원홍외선조사치료후，20 min、30 min、40 min조혈류량증치균명현고우대조조（ P＜0.05）；40 min급60 min조혈류량증치여20 min조상비명현증가（ P＜0.05）；40 min조여60 min조간혈류량증치차이무통계학의의（ P＞0.05）。20 min、30 min、40 min조경반년원홍외조사치료후，혈hsCRP급IL－8차치여대조조상비유하강추세，단차이무통계학의의（ P＞0.05）；40 min급60 min조교20 min조하강명현，차이무통계학의의（P＞0.05）；40 min조여60 min조간차이무통계학의의（P＞0.05）。결론선택매주3차，매차40 min적원홍외조사적치료방식대유지성투석환자자체동정맥내루가이체도최가효과，치득림상추엄사용。
Objective To investigate the treatment effect of far infrared radiation on autogenous arteriovenous fis -tula in patients on maintenance hemodialysis .Methods Patients on autogenous arteriovenous fistula for more than one year were divided into the 20 min group, 40 min group, 60 min group and the control group .Each group had 20 patients. The first 3 groups received far -infrared radiation for 20, 40 and 60 min at each time of dialysis, respectively, 3 times a week, for 6 months.The control group only received regular dialysis treatment .Blood flow changes and the incidence of fistula dysfunction were recorded.Levels of high-sensitivity C-reactive protein (hsCRP) and interleukin-8 (IL-8) were detected by ELISA .Results Compared with the control group , after far-infrared radiation therapy for six months , increases of blood flow in 20 min, 30 min, 40 min groups were significantly higher (P<0.05).Blood flow increase in the 40 min and 60 min groups were higher than 20 min group (P<0.05).There was no statistically significant difference in blood flow increase between the 60 min and 40 min group.After six months of far -infrared radiation therapy, serum hsCRP and IL -8 decreased compared with the control group , but the differences among 20 min, 30 min, 40 min groups were not statistically significant (P>0.05).Levels of serum hsCRP and IL -8 were lower in the 40 min group and 60 min group than the 20 min group, but similar between the 40 min group and the 60 min group.Conclusion Far-infra-red radiation session of 40 min, three times a week delivers the best treatment effects and worthy of clinical application on autogenous arteriovenous fistula in maintenance hemodialysis patients .