| Objective1.To explore the effect of a 12-week intradialytic resistant exercise on intradialytic hypotension frequency?blood pressure and blood pressure variability;2.To analysis the effects of resistant exercise on dialysis clearance,including urea?creatinine?blood calcium and blood phosphorus;3.To analysis the effects of resistant exercise on quality of life.MethodsIn the trial,we recruited 80 patients who underwent IDH frequently from 2hemo-dialysis centers.The data were collected from September 2015 to March 2016.They were at random divided into two groups by using random number table,intervention group(n=40)and control group(n=40).The control group received normal care,including: the dialysis duration was 4h per session,three times per week,with the blood flow from 180 to 280ml/min,dialysate temperature was 36?~37?,related diet guide and prevention instruction of complications and so on;while the intervention group receive 12 weeks' resistant exercise except for the normal care.The specific resistant exercise: 3 times per week for 12 weeks(overall 36 times).The intervention include 5 minutes warm-up,5 minutes relax exercise and approximately 30 minutes discontinuous intradialytic resistant exercise,paying attention to uncomfortable symptoms at any time.Blood pressure and IDH were recorded during every dialysis.The IDH,blood pressure,blood pressure variability,dialysis clearance,quality of life were assessed prior to and at the end of the program.ResultAfter 12 weeks resistant exercise,overall 77 patients finished the trial,results are as follows:1.The outcome of IDH: There were significant differences in IDH accidents(P=0.000).There were significant differences between intervention group and control group on IDH accidents during the intervention period(P<0.05).At the same time,12weeks' resistant exercise is benefit to reducing related nursing intervention times,for example,adjusting dialysate sodium concentration,reducing blood flow rate and adjusting dialysate temperature(P<0.01).2.The outcome of blood pressure: During the 12 weeks' intervention,there were differences in both pre-dialysis SBP and DBP between the two groups,the blood pressure of intervention group were lower than that of control group(P<0.01).As well as,the lowest blood pressure of intervention group were higher than that of control group(P<0.01).3.The outcome of BPV: During the 12 weeks' intervention,the blood pressure of intervention group was lower than that of control group,there were significant differences in systolic blood pressure SD and CV between the two groups(systolic blood pressure SD:t =-4.72,P =0.000;systolic blood pressure CV:t =-4.356,P=0.000),while there were no differences in diastolic blood pressure SD and CV between the two groups(P>0.05).4.The outcome of dialysis clearance: resistant exercise could increase the clearance of urea?creatinine and blood phosphate,but the differences were not significant(P>0.05).5.The outcome of life quality: After 12 weeks' intervention,there were significant differences in two dimensions in the terms of psychology,social function and mental health between the two groups.In the intervention group,the score of mental health and social function were obviously higher than those of the control group(t = 2.131-2.617,P<0.05).Conclusion1.12 weeks' resistant exercise could reduce hemodialysis patients IDH accident srate and related-IDH nursing intervention methods.2.12 weeks' resistant exercise could improve hemodialysis patients' blood pressure,reduce blood pressure variability and stable blood pressure.3.12 weeks' resistant exercise could improve hemodialysis patients' social-function and mental-health dimensions of life quality.Resistant exercise could be regarded as a common nursing care in the hemodialysis care,and it is worthy of promoting and implementation. |
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