上肢加压治疗在预防无运动能力患者经外周静脉穿刺的中心静脉导管相关血栓形成中的作用  

Effect of upper limb compression therapy on the prevention of peripherally inserted central venous catheter related thrombosis in patients with inability to exercise

作　　者：徐岁云[1] 王文旭 韩艳 高炀[1] 郭磊[1] 闫先侠 XU Suiyun;WANG Wenxu;HAN Yan;GAO Yang;GUO Lei;YAN Xianxia(Department of Neurosurgery,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Province,Xi’an 710004,China;Precision Medical Research Institute,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Province,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院神经外科,陕西西安710004 [2]西安交通大学第二附属医院精准医疗研究院,陕西西安710004

出　　处：《中国医药导报》2023年第23期135-138,181,共5页China Medical Herald

基　　金：陕西省重点研发计划项目(2022SF-396)。

摘　　要：目的观察上肢加压治疗在预防无运动能力患者经外周静脉穿刺的中心静脉导管(PICC)相关血栓形成中的作用。方法选取2020年1月至2022年8月在西安交通大学第二附属医院行上肢PICC置管术并进行导管维护的无运动能力患者84例,采用随机数字表法将其分为对照组和加压组,各42例。对照组采用被动活动干预,加压组使用空气压力波加压干预。应用彩色多普勒超声监测两组干预前和干预30 min后腋静脉和锁骨下静脉血流速度;于置管前、置管2周后,检测两组纤维蛋白原、凝血酶原时间、D-二聚体。记录两组PICC相关血栓发生情况。结果干预30 min后,两组腋静脉和锁骨下静脉血流速度均快于干预前,且加压组快于对照组,差异有统计学意义(P<0.05)。置管2周后,对照组纤维蛋白原、凝血酶原时间、D-二聚体水平高于本组置管前,且高于加压组,差异有统计学意义(P<0.05)。加压组置管前、置管2周后纤维蛋白原、凝血酶原时间、D-二聚体比较,差异无统计学意义(P>0.05)。在2周的观察期内,加压组PICC相关血栓发生率低于对照组,差异有统计学意义(P<0.05)。结论空气压力波治疗仪通过增加置管侧静脉血流速度,能有效预防无运动能力患者上肢PICC相关血栓形成。Objective To observe the effect of upper limb compression therapy on the prevention of peripherally inserted central venous catheter(PICC)related thrombosis in patients with inability to exercise.Methods A total of 84 patients with inability to exercise underwent upper limb PICC catheterization and catheter maintenance in the Second Affiliated Hospital of Xi’an Jiaotong University from January 2020 to August 2022 were selected.They were divided into control group and compression group by random number table method,with 42 cases in each group.The control group was given passive activity intervention,and the compression group was given air pressure wave intervention.Color Doppler ultrasound was used to monitor the blood flow velocity of axillary vein and subclavian vein before intervention and 30 minutes after intervention in the two groups.The levels of fibrinogen,prothrombin time,and D-dimer were measured before catheterization and two weeks after catheterization.The incidence of PICC related thrombosis in the two groups was recorded.Results After 30 minutes of intervention,the blood flow velocity of axillary vein and subclavian vein in the two groups were faster than those before intervention,and that in the compression group was faster than that in the control group,and the differences were statistically significant(P<0.05).After two weeks of catheterization,the levels of fibrinogen,prothrombin time,and D-dimer in the control group were higher than those before catheterization,and higher than those in the compression group,and the differences were statistically significant(P<0.05).There were no significant differences in fibrinogen,prothrombin time,and D-dimer before and two weeks after catheterization in the compression group(P>0.05).During the observation period of two weeks,the incidence of PICC related thrombosis in the compression group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Air pressure wave therapeutic instrument can effectively prev

关 键 词：空气压力波干预 被动活动 血流速度 经外周静脉穿刺中心静脉导管相关血栓 

分 类 号：R454[医药卫生—治疗学]