尿毒病患血液透析中之運動訓練：病例報告

Exercise Training During Hemodialysis for End-stage Renal Failure：A Case Report

周偉倪(Wil-Ly Chou) ； 張光遜(Kuang-Shin Chang) ； 龍淑慧(Su-Hwei Long) ； 高木榮(Mu-Jung Kao) ； 郭振楠(Chen-Nan Go)

《中華民國復健醫學會雜誌》 26卷2期 (1998/06) Pp. 95-101

摘要

運動訓練，尤其是有氧運動，對人體有多方面的益處，對尿毒病人亦有相似的功效，然而在非洗腎期給予運動訓練治療，往往因病人遵行醫囑不佳，使治療效果大打折扣，甚至達不到預期效果。
本研究提出一位尿毒病患給予三個月無運動訓練的控制期及另外三個月洗腎中的運動訓練期，發現遵行醫囑率達34／36（94.4%），相對於控制期，運動訓練後最大耗氧量增加37.8％，血壓及休息心跳下降至正常範圍內而停止使用高血壓藥，血脂肪中三酸甘油脂及膽固醇下降42mg/dl及38mg/dl，高密度脂蛋白上升10.2mg/dl，較控制期（-10 ,+4及+1）有明顯差異。Zung憂鬱量化分數由62分下降至41分，但血中紅血球、血色素、血球容積率及血尿氮素、肌甘酸、尿酸濃度則無明顯改變。故得知，在血液透析中進行運動訓練，是一種安全的心肺復健，而且可藉由提升遵行醫囑率，來達到預期的效果。

關鍵字

運動訓練 ； 血液透析 ； 運動測試 ； 慢性腎衰竭

並列摘要

Exercise training, especially aerobic exercise, is beneficial to one's health. This is also true for end-stage renal failure patients. However, exercise programs prescribed on non-dialysis days are not usually carried out by the patients, which can decrease the expected effectiveness of exercise training.
We present an uremic patient who first underwent a 3 month non-exercise control period, then immediately followed by another 3 months of exercise training during hemodialysis, with a stationary bike. We found the patient's compliance rate for exercise training was 94% (34/36). His maximal oxygen consumption increased by 37.8%, and he was able to discontinue his anti-hypertensive agents due to a normalization of his resting blood pressure and heart rate. Cholesterol and triglyceral levels decreased by 42 and 38 mg/dl, and HDL levels increased by 10.2 mg/dl, as compared with his non-exercise period results (+10, +4 and –1 mg/dl). The patient's Zung depression score also decreased from 62 to 41. However, no significant difference was noted in the RBC, Hb, Hct, BUN, creatinine, and uric acid levels between the two periods. We can conclude that exercise training performed in end-stage renal failure patients during hemodialysis is a safe form of cardiopulmonary rehabilitation. and the high compliance rate, can assure the expected results of exercise training.

並列關鍵字

exercise training ； hemodialysis ； exercise test ； chronic renal failure