手部运动操预防老年消化道肿瘤患者PICC相关上肢静脉血栓的效果观察

Effect of hand exercises on prevention of upper extremity venous thrombosis in elderly patients with gastrointestinal cancer

目的探讨手部运动操对预防老年消化道肿瘤患者经外周中心静脉置管(peripherally inserted central catheter,PICC)术后相关上肢静脉血栓的效果。方法选择120例PICC置管术后的老年消化道肿瘤患者,按置管顺序,单数分为对照组(常规护理)和双数分为观察组(常规护理加实施手部运动操),比较两组患者术前、术后3周置管侧腋静脉流速、血液流变学及PICC相关静脉血栓发生率。结果术后3周观察组腋静脉流速较对照组加快,两组比较,差异具有统计学意义(P<0.05);观察组PICC相关静脉血栓发生率较对照组降低,两组比较,差异具有统计学意义(P<0.05);除白小板计数和凝血酶原时间外,观察组的D-二聚体较对照组少,两组比较,差异具有统计学意义(P<0.05)。结论实施手部运动操能改善老年消化道肿瘤患者PICC置管上肢的血液循环,减少PICC相关上肢静脉血栓的发生。

Objective To investigate the effect of hand exercises on venous thrombosis in the upper extremities of elderly patients with gastrointestinal cancer after the peripherally inserted central venous catheteration（PICC）. Methods One hundred and twenty elderly patients with gastrointestinal tumors after PICC were divided into the control group and experiment group： the former received routine care and the latter with routine care plus hand exercises. The two groups were compared in terms of blood flow in axillary vein, blood rheology and incidence of upper extremity venous thrombosis before and after surgery. Result Three weeks later, compared with control group, the axillary vein flow velocity of the experiment group significantly was accelerated（P〈0.05） and the incidence of upper extremity venous thrombosis was significantly reduced（ χ~2= 4. 90, P〈0. 05）. Conclusion The implementation of the hand exercises can significantly improve the blood circulation in the upper extremities of the elderly patients with gastrointestinal cancer, and prevent the occurrence of upper extremity venous thrombosis.