上肢康复训练联合微波热疗对经外周静脉穿刺中心静脉置管术乳腺癌患者的影响

Effect of upper limb rehabilitation training combined with microwave hyperthermia for breast cancer patients undergoing peripherally inserted central catheter

  • 摘要:
      目的  探讨上肢康复训练联合微波热疗对乳腺癌患者经外周静脉穿刺中心静脉置管术(PICC)后静脉血流及血栓的影响。
      方法  选取行PICC置管的乳腺癌患者80例为研究对象,采用随机数字表法分为对照组和观察组,每组40例。对照组接受常规护理干预,研究组接受上肢康复训练联合微波热疗干预。比较2组置管前后腋静脉血流速(Vmax)、单位时间平均血液流速(TMFV)、凝血功能指标水平,同时比较2组血栓及导管相关并发症发生率。
      结果  观察组置管后21、28 d腋静脉Vmax和腋静脉TMFV高于对照组,差异有统计学意义(P < 0.05)。置管28 d后,观察组PT、APTT高于对照组,FIB水平低于对照组,差异有统计学意义(P < 0.05)。2组上肢静脉血栓发生率比较,差异有统计学意义(P < 0.05),但2组导管相关并发症发生率比较,差异无统计学意义(P>0.05)。
      结论  上肢康复训练联合微波热疗能够增加乳腺癌PICC患者腋静脉血流量,改善血液凝血指标水平,降低血栓发生率,且不增高导管相关并发症发生率。

     

    Abstract:
      Objective  To investigate the effect of upper limb rehabilitation training combined with microwave hyperthermia on venous blood flow and thrombus after peripherally inserted central catheter (PICC) catheterization in breast cancer patients.
      Methods  A total of 80 breast cancer patients with PICC catheterization were divided into control group and observation group, with 40 cases in each group. The control group received routine nursing intervention and the observation group received upper limb rehabilitation training combined with microwave hyperthermia intervention. The maximal velocity(Vmax), time mean flow velocity(TMFV) of axillary vein and coagulation function indexes before and after catheterization were compared between the two groups, and the incidence rates of thrombus and catheter-related complications were compared between the two groups.
      Results  The Vmax and TMFV of axillary vein in the observation group were higher than those in the control group at 21 and 28 days after catheterization (P < 0.05). After 28 days of catheterization, PT and APTT in the observation group were significantly higher, while FIB level in the observation group was significantly lower than that in the control group (P < 0.05). There was statistically significant difference in the incidence of venous thrombosis of upper limb between the two groups (P < 0.05), but there was no statistically significant difference in the incidence of catheter-related complications between the two groups (P>0.05).
      Conclusion  Upper limb rehabilitation training combined with microwave hyperthermia can increase blood flow of axillary vein, improve blood coagulation indexes, reduce the incidence of thrombus and not increase the incidence of catheter-related complications in patients with breast cancer undergoing PICC.

     

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