【摘要】目的 了解维持性血液透析患者(maintenance hemodialysis，MHD)透析中运动康复的退出情况，为临床更好的开展和管理MHD 患者透析中运动康复提供依据。方法对“运动康复对维持性血液透析患者生活质量影响”多中心随机对照研究中的入选患者进行问卷调查，了解透析中运动康复的退出率及原因。结果① 6 家血液透析中心入组患者202 例(运动组99 例，非运动组103 例)；一年期退出研究29 例(占实际入组患者总数14.4%)。②运动组退出21 例(21.2%)，对照组退出8 例(7.8%)，2 组退出率比较有统计学差异(χ2=7.422，P=0.006)。总体退出原因中客观原因占82.8%，主观原因占17.2%。③退出与未退出患者的透析龄(U=1835.500，Z=-2.311，P=0.021)、跌倒评分(U=2043.500，Z=-2.618，P =0.009)比较有统计学差异；睡眠评分、家庭支持、近1 个月并发症总数等比较无统计学差异。结论透析中运动康复退出率不高，运动与非运动组均以客观原因退出为主，适度的透析中运动安全性好，但患者教育及系统管理对长期开展临床透析中运动康复非常必要。

【Abstract】Purpose The status of quo and dropout of intradialysis exercise in maintenance hemodialysis (MHD) patients was investigated in order to provide better strategies for the clinical management of exercise rehabilitation in MHD patients. Methods Questionnaire were designed to ask patients to participate in a multicenter randomized controlled study called "exercise rehabilitation on the quality of life in MHD patients" to investigate the situation and cause of dropout of intradialytic exercise. Results ①A total of 202 patients (99 in exercise group and 103 in non-exercise group) were recruited from 6 hemodialysis centers, and 29 of them (14.4%) dropped out of intradialytic exercise during the study. ②Twenty-one patients (21.2%) in the exercise group and 8 patients (7.8%) in the control group dropped out of intradialytic exercise (χ2=7.422 and P=0.006 between the two groups). In the dropout causes, objective causes accounted for 82.8% and subjective causes accounted for 17.2%. ③ The differences were statistically significant in dialysis age ( U = 1835.500, Z = -
2.311, P=0.021) and the score of falling down to the ground (U=2043.500, Z=-2.618, P=0.009) between dropout patients and non-dropout patients. There were no statistical differences in sleep score, family support and total number of complications in a recent month. Conclusion The overall dropout rate of intradialytic exercise rehabilitation was lower. Objective causes accounted mainly for the dropout both in exercise group and non-exercise group. Moderate intensity of intradialysis exercise was safe. Education and systematic management of the patient are necessary to the implementation of long-term intradialytic exercise rehabilitation.