经桡动脉行心导管介入术后三种手部功能锻炼方式的比较研究

Comparison of the effects of three kinds of hand exercises on improving limb function in patients after transradial cardiac catheterization

目的 旨在比较3种手部功能锻炼方式缓解经桡动脉心导管介入治疗术后患者不适的效果.方法 本研究为单中心、随机对照临床试验,于2020年8月至2021年6月选取南京市1所三级甲等医院临床中102例患者为研究对象,随机分为手指操组(n=34)、穴位按摩组(n=34)和握力锻炼组(n=34).在干预后的第1、2、4和24 h进行相关评价指标的监测,并将肿胀和疼痛作为主要结局指标、出血程度和皮肤温度作为次要结局指标.结果 最终99例患者完成研究.握力锻炼组的患者手掌肿胀在干预后2、4 h(H=6.710,P=0.035;H=10.060,P<0.001)逐渐缓解.以中指为例的握力锻炼组患者手指肿胀在干预后2、4 h(H=9.353,P<0.001;H=10.699,P<0.001)较其他两组也明显减轻.握力锻炼组患者在干预后4 h(H=7.048,P=0.029)疼痛评分明显降低.但3组患者术侧肢体手部皮温(H=0.922,P=0.631)和穿刺部位出血程度(H=0.123,P=0.940)差异无统计学意义.结论 本研究发现握力锻炼比手指操和穴位按摩更能有效减少肢体水肿.

Objectives This study aimed to compare effects of different hand exercises on improving limb function in patients after transradial cardiac catheterization.Methods This single-center,randomized clinical trial was conducted from August 20,2020,to July 20,2021,at an academic medical center.A total of 102 participants were selected from a Class A tertiary hospital in Nanjing,China and randomized into three groups:finger exercise group(n=34),acupoint massage group(n=34),and handgrip exercise group(n=34).Symptoms of edema and pain were defined as primary outcomes,while skin temperature and degree of bleeding as secondary outcomes,which were monitored and measured 1,2,and 4 h,after the intervention.Results Among the 99 participants who completed the process,the palm edema was gradually relieved in the handgrip exercise group at 2 h(H=6.710,P=0.035)and 4 h(H=10.060,P<0.001)following the intervention.The edema of fingers in the handgrip exercise group was obviously relieved at 2 h(H=9.353,P<0.01)and 4 h(H=10.699,P<0.001)following the intervention compared with the other two groups.In addition,the pain score at 4 h(H=7.048,P=0.029)was clearly decreased in the handgrip exercise group.However,there was no significant difference in the punctured limb’s skin temperature(H=0.922,P=0.631)and the degree of bleeding(H=0.123,P=0.940)among the three groups.Conclusions We found that handgrip exercise is more effective in reducing the edema of the limbs than finger exercise and acupoint massage.