握拳运动对预防PICC相关性静脉血栓形成效果的Meta分析  

The effects of handgrip exercise in reducing peripherally inserted central catheter-related venous thrombosis:a Meta-analysis

作　　者：劳月文 陈香萍[1] 汪萍 项盛芳 高卿卿[1] 庄一渝[1] Lao Yuewen;Chen Xiangping;Wang Ping;Xiang Shengfang;Gao Qingqing;Zhuang Yiyu(Intensive Care Unit of Sir Run Run Shaw Hospital,Medical School of Zhejiang University,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院ICU,杭州310016

出　　处：《中国实用护理杂志》2019年第36期2869-2874,共6页Chinese Journal of Practical Nursing

基　　金：浙江大学附属邵逸夫医院护理科研基金(201703HL)。

摘　　要：目的通过系统评价握拳运动对预防PICC相关性静脉血栓形成的效果,从而指导临床实践.方法计算机检索Cochrane、PubMed、CINAHL、Embase、知网、万方、生物医学文献数据库,收集所有握拳运动对预防PICC相关性静脉血栓形成效果的研究.由2名研究者独立进行文献检索、文献筛选、质量评价核资料提取,并对合格研究进行描述或Meta分析.结果共有7篇文献符合纳入标准,均为随机对照试验,对其中7个研究进行了Meta分析,结果显示:握拳运动较常规运动PICC相关性静脉血栓的发生率低(RR=0.27,95%CI 0.17~0.42,P<0.01);增加了腋静脉最大血液流速,合并效应有统计学意义(WMD=6.53,95%CI 3.34~9.73,P<0.01);增加了腋静脉单位时间平均血液流速,合并效应有统计学意义(WMD=6.05,95%CI 3.24~8.87,P<0.01).结论握拳运动可改善腋静脉血流速度,降低PICC相关性静脉血栓的形成,但未来仍需开展大样本、高质量的随机对照试验进一步评价握拳运动在PICC患者中的应用效果.Objective To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise.Methods A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis,using the Cochrane Library and the databases of PubMed,CINAHL,Embase,CNKI,WanFang and CBM.The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies.Results Seven RCTs were included in a total of 789 patients.Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis(RR=0.27,95%CI 0.17-0.42,P<0.01);and improving vein maximum velocity(WMD=6.53,95%CI 3.34-9.73,P<0.01)and time-mean flow velocity(WMD=6.05,95%CI 3.24-8.87,P<0.01).Conclusions Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis.Due to a small number of included studies and heterogeneity of indicators,multi-centered,high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.

关 键 词：经外周静脉置入中心静脉导管 握拳运动 静脉血栓 META分析 

分 类 号：R47[医药卫生—护理学]