精准握力训练对肿瘤PICC带管患者置管静脉血流动力学的影响

Effect of precise grip strength training program on venous blood flow dynamics in patients with tumor PICC catheterization

目的探讨精准握力训练对肿瘤经外周置入中心静脉导管(PICC)带管患者置管静脉血流动力学的影响。方法选取2022年7-12月山东第一医科大学第一附属医院收治的首次置入PICC并在此继续进行维护工作的210例肿瘤化疗患者,按随机数字表法分为对照组、观察1组和观察2组,各70例,中途对照组有1例患者因死亡而退出,观察2组有1例因依从性差而主动退出,最终共纳入208例肿瘤化疗患者,其中对照组69例,观察1组70例,观察2组69例。对照组采用PICC置入常规健康教育进行宣教;观察1组在对照组基础上采用握力训练最佳持续-放松时间(即持续2s-放松2s);观察2组在对照组基础上采用精准握力训练。在超声监测下记录不同阶段对置管侧静脉的平均血流速度、握球时的最大血流速度及握力。结果观察2组平静状态下置管侧静脉的平均血流速度、握球时最大平均血流速度及握力明显高于观察1组与对照组(P<0.05)。结论精准化握力训练可有效提高肿瘤化疗带管患者平均血流速度,并显著提高患者握力训练的锻炼效率与依从性,对导管相关性血栓的发生具有一定预防作用。

Objective To explore the effects of precise grip strength training programs on hemodynamics on the side of catheterization in tumor patients with peripherally inserted central catheter(PICC).Methods A total of 210 tumor chemotherapy patients admitted to implant PICC for the first time and continue to maintenance the work in the First Affiliated Hospital of Shandong First Medical University from July to December 2022 were selected and divided into the control group,the observation group 1,and the observation group 2 according to the random number table method,with 70 cases in each group.During the intervention,one patient in the control group withdrew due to death,while one patient in the observation group 2 voluntarily withdrew due to poor compliance.A total of 208 patients with tumor chemotherapy were finally enrolled,including 69 cases in the control group,70 cases in the observation group 1,and 69 cases in the observation group 2.Patients in the control group received routine health education for PICC placement,the observation group 1 was given the optimal persistence-relaxation time of grip strength training(lasting 2 s and relaxing 2 s)on the basis of the control group,and the observation group 2 was adopted precision grip strength training on the basis of the control group.The average blood flow velocity,maximum blood flow velocity and grip strength of the side veins of the opposite catheter at different stages were recorded under ultrasonic monitoring.Results The average blood flow velocity,the maximum average blood flow velocity,and the grip strength of the side vein in the static state in the observation group 2 were significantly higher than those in the observation group 1 and the control group(P<0.05).Conclusion Precise grip strength training can effectively improve the average blood flow velocity of patients with tumor chemotherapy belt,and can significantly improve the exercise efficiency and compliance of patients with grip strength training,so as to have a certain preventive effect on the occurrence of catheter-related thrombosis.