旋腕运动护理对PICC术后静脉血栓形成的预防效果  

Preventive effects of wrist movement nursing on venous thrombosis after PICC

作　　者：张丽华[1] 王莉菲[1] 刘晓娜 Zhang Li-hua;Wang Li-fei;Liu Xiao-na(The First Department of Orthopedics,Zhengzhou People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院骨一科,河南郑州450000

出　　处：《四川生理科学杂志》2021年第1期74-77,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨针对经外周置入中心静脉导管术(Peripherally inserted central catheters,PICC)患者采取旋腕运动对静脉血栓形成的预防效果。方法:回顾性分析我院2017年3月至2019年12月行PICC术的136例恶性肿瘤患者的临床资料,根据护理模式不同将其分为对照组(n=69)和观察组(n=67)。对照组患者采取常规护理,观察组患者在此基础上采取旋腕运动护理。利用彩色多普勒超声系统及全自动生化分析仪评价两组患者干预前、干预15 d后血流动力学、血液流变学指标:全血低切粘度(Low shear rate Blood Viscosity,LBV)、全血高切粘度(High blood viscosity,HBV)、红细胞比积(Hematocrit in blood,Hct)、血浆粘度(Plasma viscosity,PV)、凝血指标:凝血酶原时间(Prothrombin time,PT)、纤维蛋白酶原(Fibrinogen,Fbg)、血栓烷素B2(ThromboxaneB2,TXB2)、D-二聚体(D-Dimer,D-D)的变化,并观察记录静脉血栓的发生情况。结果:干预后,观察组腋下最大血流流速和腋下平均血流速度明显高于对照组(P<0.05);观察组LBV、HBV、PV、Hct、PT较对照组高(P<0.05);Fbg、TXB2、D-D均较对照组低(P<0.05);观察组静脉血栓发生率低于对照组(P<0.05)。结论:针对PICC术患者采取旋腕运动护理,简单易行,对改善患者血液粘度、减少静脉血栓发生有着积极意义。Objective:To investigate the preventive effects of wrist movement on venous thrombosis after peripherally inserted central catheter(PICC)in patients.Methods:The clinical data of 136 patients with malignant tumor who underwent PICC in the hospital from March 2017 to December 2019 were retrospectively analyzed.All the patients were assigned into control group(n=69)and observation group(n=67)according to different nursing modes.Control group was given routine nursing,and observation group was given wrist movement nursing based on control group.The changes of hemodynamics and hemorheology indexes[low shear blood viscosity(LBV),high shear blood viscosity(HBV),hematocrit(Hct),plasma viscosity(PV)],coagulation indexes[prothrombin time(PT),fibrinogen(Fbg),thromboxane B2(TXB2),D-dimer(D-D)]in the two groups were evaluated by color Doppler ultrasound system and fully automatic biochemical analyser before intervention and after intervention for 15d,and the incidence of venous thrombosis was observed and recorded.Results:The maximum axillary flow velocity and mean axillary flow velocity in observation group were significantly higher than those in control group after intervention(P<0.05).The LBV,HBV,PV,and Hct in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).The PT of observation group was higher than that of control group,while the Fbg,TXB2 and D-D in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).The incidence of venous thrombosis in observation control group(2.99%)was lower than that in control group(13.04%),and the difference was statistically significant(P<0.05).Conclusion:Wrist movement nursing for patients with PICC is simple and easy to operate,which is of positive significance for improving blood viscosity and reducing the incidence of venous thrombosis.

关 键 词：静脉血栓 旋腕运动 PICC术 血液流变学 

分 类 号：R47[医药卫生—护理学]