A prospective clinical study of functional exercises beforearteriovenostomy

Objective To study the effect of preoperative functional exercises on the success rate of arteriovenostomy and postoperative complications.Methods The subjects were randomly divided into two groups:preoperative non-exercise group and preoperative exercise group.The age,sex,APACHE Ⅱ score and serum Cystatin C value before operation,and cephalic vein diameter,hemoglobin,platelet,albumin,and cholesterol two months before operation and on the operation day were collected.And the subjects were observed for half a year after operation.The observation indicators included the success of internal fistula surgery,the maturation time of internal fistula,the use time of internal fistula,the blood flow of the brachial artery,and postoperative complications.And the differences between the groups were analyzed.Results There were 75 patients in the non-exercise group and 76 patients in the two-month exercise group.Overall success rate of surgery was 92.1%.The success rate of preoperative exercise group was 94.7%,and that of preoperative non-exercise group was 89.3%,with statistically significant difference between the two groups(P=0.03).The preoperative exercise group had a blood flow at the fistular orifice more than the non-exercise group by 38.8 ml/min.The average fistular maturation time in the exercise group was shorter than that in the non-exercise group by 4 days,with statistically significant difference between the two groups.However,there were no significant differences between the two groups in the comparison of the use time of internal fistula and the incidence of postoperative complications.Conclusions Functional exercises before arteriovenostomy can improve the success rate of surgery and increase the brachial blood flow,but it does not prolong the survival time of internal fistula or reduce the complication incidence.