Abstract:

Objective To systematically evaluate the effect of different types of exercise in improving the dialysis adequacy of patients undergoing hemodialysis. Methods The databases of PubMed，Cochrane Library，Embase，Web of Science，WanFang，CNKI，VIP，and CBM were searched for the articles related to the effectiveness of exercise on the dialysis adequacy of patients undergoing hemodialysis，from inception to 1st January，2022. After literature screening and data extraction，Cochrane risk of bias tool 2.0 was used for quality evaluation. RevMan 5.3 and STATA 16.0 software were used for statistical analysis. Results 30 studies with 1 216 participants and 9 types of exercise were included. The results of the network meta-analysis showed that intradialytic combined aerobic and resistance exercise and intradialytic aerobic exercise were the top 2 types in improving the single pool clearance index on hemodialysis patients. Intradialytic aerobic exercise and intradialytic combined aerobic and resistance exercise were the top 2 types in improving the urea reduction ratio of hemodialysis patients. Conclusion The dialysis adequacy of hemodialysis patients can be improved by a variety of exercise，especially intradialytic combined aerobic and resistance exercise，and intradialytic aerobic exercise.

Key words: Hemodialysis, End-Stage Renal Disease, Exercise, Dialysis Adequacy, Network Meta-Analysis, Evidence-Based Nursing

摘要：

目的 系统评价不同运动方式对提高血液透析患者透析充分性的效果。方法 系统检索PubMed、Cochrane Library、Embase、Web of Science和万方数据库、中国知网、维普数据库、中国生物医学文献数据库等中英文数据库中关于运动干预对改善血液透析患者透析充分性的文献，检索时限为建库至2022年1月1日。经文献筛选和资料提取，采用随机对照试验Cochrane偏倚评估工具2.0版本进行文献质量评价，采用RevMan 5.3和STATA 16.0软件进行统计分析。结果 最终纳入30项研究，共1 216例患者，9种运动方式。网状Meta分析结果显示，透析中有氧联合抗阻运动和透析中有氧运动对提高血液透析患者单室尿素清除指数的效果在9种运动中位于前2名；透析中有氧运动和透析中有氧联合抗阻运动对提高血液透析患者尿素减少率的效果在6种运动中位于前2名。结论 多种运动方式能够提高血液透析患者的透析充分性，尤其以透析中有氧联合抗阻运动、透析中有氧运动的效果最为明显。

关键词: 血液透析, 终末期肾脏病, 运动, 透析充分性, 网状Meta分析, 循证护理学