Objective: To explore the effect of different exercise modes on prevention of peripherally inserted central catheter related venous thrombus (PICC-related VT) in elderly cancer patients. Methods: 153 cases elderly cancer patients who received PICC catheterization in our hospital from October 2017 to November 2019 were divided into the handgrip exercise group (50 cases), ball-holding exercise group (52 cases), and arm exercise group (51 cases). Before and after 1, 2, 4 weeks of PICC carrying, the maximum velocity (Vmax), time-mean flow velocity (TMFV) of axillary vein were measured by color Doppler ultrasound, and the incidence and severity of PICC-related VT were compared among the three groups.Results: With the extension of the exercise time after catheterization, the Vmax and TMFV of axillary vein in the three groups showed a gradually increasing trend, and there were significant differences among the three groups (P<0.05). The degree of increasedVmax in arm exercise group was more than that in handgrip exercise and ball-holding exercise group (P<0.05). Within 4 weeks after catheterization, the incidence of PICC-related VT was 28.0%, 23.1% and 7.8%, respectively, inhandgrip exercise group, ball-holding exercise group andarm exercise group. The incidence and severity of PICC-related VT in arm exercise group was lower than that in the other two groups with statistical differences (P<0.05). There was no statistically significant difference in blood flow velocity and incidence of PICC-related VT between handgrip exercise and ball-holding exercise group (P>0.05).Conclusion: The effect of arm exercise on improving blood flow velocity of PICC catheter vein and preventing PICC-related VT in elderly cancer patients is better than that of handgrip exercise and ball-holding exercise, which is worthy of clinical promotion. |
[1] BERTOGLIO S,FACCINI B,LALLI L,et al.Peripherally inserted central catheters (PICCs) in cancer patients under chemotherapy:a prospective study on the incidence of complications and overall failures[J].J Surg Oncol,2016,113(6):708-714.
[2] LISCYNESKY C,JOHNSTON J,HAYDOCY K E,et al.Prospective evaluation of peripherally inserted central catheter complications in both inpatient and outpatient settings[J].Am J Infect Control,2017,45(9):1046-1049.
[3] GORSKI L A.The 2016 infusion therapy standards of practice[J].Home Healthc Now,2017,35(1):10-18.
[4] 张建薇,傅荣.握拳运动在预防老年PICC置管患者上肢深静脉血栓中的应用效果[J].中华现代护理杂志,2018,24(4):440-442.
[5] 娄英华,沈怡.Caprini血栓风险评估模型预测妇科恶性肿瘤手术患者DVT风险的有效性研究[J].东南大学学报(医学版),2017,36(3):333-337.
[6] 惠慧,马燕兰,郭梅,等.恶性肿瘤病人PICC相关性血栓风险因素及护理干预研究进展[J].护理研究,2019,33(5):811-816.
[7] 劳月文,陈香萍,汪萍,等.握拳运动对预防PICC相关性静脉血栓形成效果的Meta分析[J].中国实用护理杂志,2019,35(36):2869-2874.
[8] LIU K,ZHOU Y,XIE W,et al.Handgrip exercise reduces peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers:a randomized controlled trial[J].Int J Nurs Stud,2018,86(6):99-106.
[9] 李雪娇,皮红英.上肢加压与握拳运动方案对PICC置管患者血流动力学的影响[J].中华现代护理杂志,2018,24(27):3259-3262.
[10] 周晔,刘扣英,崔焱.预防PICC术后深静脉血栓形成的最佳握拳运动[J].江苏医药,2015,41(11):1303-1305.
[11] 王婷,王娟琇,夏定菊.六步上肢锻炼操降低乳腺癌化学药物治疗患者PICC导管相关性血栓发生率[J].临床与病理杂志,2019,39(9):1989-1993.
[12] CHOPRA V,KAATZ S,GRANT P,et al.Risk of venous thromboembolism following peripherally inserted central catheter exchange:an analysis of 23,000 hospitalized patients[J].Am J Med,2018,131(6):651-660.
[13] 蒿若楠,胡芳,唐万斌.手臂操预防胃肠肿瘤患者置入PICC后并发静脉血栓的效果观察[J].护理学报,2016,23(7):19-21. |