摘要
目的观察不同握拳锻炼模式对PICC前后贵要静脉血流速度及血管内径的影响，探讨握拳锻炼的最佳模式。方法选取行PICC的患者60例，随机分为A、B、C3组各20例；A组常规指导患者徒手握拳锻炼；B组采用电子握力器握拳锻炼模式：握力弱档，25下／min，每次握拳2min休息5min重复进行，循环持续30min，每天重复上述模式4次，每隔4h1次；C组与B组模式相同，但每天重复上述模式6次，每隔3h1次。在彩色多普勒超声下观察患者置管前1h及置管后1h、第1，3，7，10，14，21天贵要静脉血流速度及血管内径变化情况。结果PICC前后各组内贵要静脉血流速度在不同时间比较差异有统计学意义（F=2．934，P〈0．05），B、C组电子握力器握拳锻炼模式较A组徒手锻炼模式更能有效加快血流速度，其中以C组效果最佳，且3组间两两比较差异有统计学意义；PICC前后各组内血管内径在不同时间比较差异有统计学意义（F=3．940，P〈0．05）；3组置管前1h和置管后1h血管内径比较差异有统计学意义。结论握拳锻炼可有效促进PICC置入上肢静脉血流速度，但对血管内径影响不大；采用电子握力器以弱档水平、25下／min、每次握拳2min的模式，6次／d，每3h1次可明显促进PICC后上肢血液循环。
Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise. Methods 60 patients with PICC were chosen and divided into group A, B and C with 20 patients in each groups. Group A received routine guidance on unarmed handgrip exercise, group B used electronic handgrip, the frequency was 25 times/min, the time period was 2 min with 4 times a day, once every 4 hours, group C adopted the same model as that of group B and 6 times a day, once every 3 hours. The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultra- sound one hour before the PICC placement and one hour, 1 day, 3 days, 7 days, 10 days, 14 days, 21 days after placement. Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points （F=2.934,P 〈 0.05）. The effect of group B and C was better than that of the group A and group C showed the best effect. The blood vessel diameter before and after PICC placement had significant differences at different time points（F=3.940,P 〈 0.05）. There was significant differences in the blood vessel diameter lh before and lh after PICC placement. Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC, but shows little effect on the blood vessel diameter. Using the electronic hand grip in weak tap position, 25 times/min, 2 min every time, and 6 times a day （once every 3 hours）, can obviously promote the upper limb venous blood flow velocity.
出处
《中国实用护理杂志》
2015年第2期94-98,共5页
Chinese Journal of Practical Nursing
基金
山东省医药卫生科技发展计划项目（2014WS0481）
关键词
经外周静脉置入中心静脉导管
握拳锻炼
血流速度
血管内径
Peripherally inserted central catheter
Handgrip exercise
Color Doppler ultrasound
Blood flow velocity
Blood vessel diameter
作者简介
通信作者：方秀新，Email：xiuxinf@sohu．com
