遠紅外線治療對末期腎病病人動靜脈管功能之統合分析

Effects of Far-Infrared Therapy on the Functional Maintenance of Arteriovenous Fistula in Patient with End-Stage Renal Disease: A Meta-Analysis

動靜脈瘻管功能不良及失效，會影響末期腎病病人執行血液透析的效率，增加罹病率與死亡率。因此，如何維持瘻管通暢及功能是重要照護議題。本研究以系統性文獻回顧探討遠紅外線照射對瘻管血流量、通暢率及失效率之成效。以關鍵字搜尋中英文次級及初級資料庫，共納入3 篇隨機對照試驗及2 篇系統性文獻回顧，以Review manager 5.2 分析遠紅外線治療之成效，一年後瘻管失效率的勝算比 (OR) =0.35, 95% CI [0.22, 0.55], p<.00001；瘻管通暢率OR = 2.12, 95% CI[1.44, 3.11], p = .0001；瘻管血流量照射前後之差異，實驗組較控制組在一年後平均差(MD) 為129.62 ml/ min, 95% CI [73.05, 186.18], p< .00001。此結果支持將遠紅外線照射列為瘻管的保養措施之一，應建立儀器操作規範及標準流程，加強病人使用安全。

Malfunction of arteriovenous fistula (AVF) affects patients with end-stage renal disease and increases the rates of morbidity and mortality. Therefore, maintenance of AVF patency is a crucial concern. The objective of this systematic review was to explore the effectiveness of far-infrared therapy on AVF blood fl ow, patency, and malfunction. Chinese and English secondary and primary databases were searched using relevant keywords; subsequently, three randomized controlled trials (RCTs) and two systematic review studies were shortlisted. Data from the three RCTs were included in the meta-analysis, pooled and evaluated using Review Manager 5.2. The pooled odds ratio (OR) for AVF malfunction and AVF patency were 0.35 (95% confi dence interval (CI) [0.22, 0.55], p < .00001), and 2.12 (95 % CI [1.44, 3.11], p = .0001), respectively; blood-flow velocity mean difference (MD) was 129.62 mL/min, (95% CI [73.05, 186.18], p < .00001) after 1 year in the experimental group. The fi ndings support previous results that revealed improvement in fi stula maintenance through far-infrared therapy. Establishing operational procedures and standards increased patient safety.