pISSN : 2383-6415   eISSN : 2383-6423

Effects of Structured Arm Exercise on Arteriovenous Fistula Stenosis in Hemodialysis Patient


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INFORMATION : page. 300~307 / 2012 Vol.14 No.4


ABSTRACT

최근 과학과 의료의 발달 및 수명 연장에 따른 노인인구의 증가로 인해 신부전에 이환될 가능성이 높아졌으며, 말기 신부전증의 주요 원인인 당뇨병과 고혈압 환자가 증가하고 있어, 신 대체 요법을 필요로 하는 말기 신부전증 환자가 급격히 증가하고 있다(Kim, 2008). 대한 신장 학회 등록위원회(2010)의 조사에 의하면 국내의 신 대체요법을 받고 있는 말기 신부전증 환자 수는 해마다 증가하여 처음 조사된 1986년에 2,534명이던 환자수가 2009년에는 56,396명으로 22배 이상으로 되었으며 계속 증가할 전망이다. 이중에서 혈액투석을 받고 있는 환자 수는 37,391명으로 66.3%를 차지하고 있다. 혈액투석의 효율을 높이기 위해 무엇보다 적절한 혈관통로의 조성 및 기능유지는 매우 중요한데(Hwang, 2006; Kim, 2008; Park, 2002) 동정맥루 이용 혈관은 제한되어 있기 때문에(Lee, 2004; Moon et al., 2006) 사용 혈로확보를 위한 혈관의 관리가 혈액 투석환자 간호 중 중요한 문제로 대두되고 있다.

Purpose: The purpose of this research was to develop and prove the effectiveness of structured arm exercise, which was used to reduce Arteriovenous Fistula (AVF) and Arteriovenous graft (AVG) stricture of hemodialysis patients. Methods: Quasi-experimental research design with non-equivalent control group was applied. 26 Subjects were participated in this study. 12 of hemodialysis patients who do not have a normal range of Static Intra Access Pressure Vein (SIAPV) score in the last three months were assigned to the experimental group and 14 patients who have a normal range of SIAPV score in the last three months to the control group. To analyze the collecting data after structured arm exercise, non parametric method with the repeated measures ANOVA by the Friedman test and Wilcoxon Signed Ranks Test for post-hoc test was performed. Results: Unlike the experimental group after three months, the control group’s SIAPV data went over the normal range. The experimental AVF group showed a difference in data after month 2 and month 3. - In AVG group, there were clear differences in each month of the test. Conclusion: This study proved that structured arm exercise therapy could be a simple and effective intervention. It is suggested to be actively utilized for hemodialysis patients.

Keyword :

Hemodialysis patient,Stenosis in arteriovenous fistula,Structured arm exercise,혈액투석환자,동정맥루 협착,구조화된 상지운동


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