Abstract:

Objective　To explore the effects of different ball holding methods on axillary vein blood flow velocity, catheter-related thrombosis (CRT) prevention, and exercise fatigue in patients with hepatocellular carcinoma who are treated by chemotherapy and take peripherally inserted central catheter (PICC). Methods　One hundred and five patients with hepatocellular carcinoma who were treated by chemotherapy and took PICC at First Hospital, Henan University of Science and Technology from October 2020 to November 2022 were retrospectively selected as the study objects, and were divided into a routine group (52 cases) and a regular group (53 cases) according to the ball holding methods. There were 27 males and 25 females in the routine group; they were (51.77±11.71) years old. There were 29 males and 24 females in the regular group; they were (52.13±12.28) years old. The routine group held the ball for about 500 times in three times every day. The regular group held the ball 25-30 times after the meals every day, and gripped it tightly for 10 s and released it 10 s each time; the grip strength was determined by squeezing the grip ball to 1/2. The axillary vein blood flow velocities, incidences of CRT, mechanical phlebitis, and catheter displacement, and exercise fatigue were compared between the two groups. t test, Fisher's exact test, and rank sum test were used. Results　Four weeks after catheter insertion, the maximum velocity of axillary vein and the velocity of axillary vein per unit time in the regular group were higher than those in the conventional group [(14.61±2.03) cm/s vs. (11.56±1.32) cm/s and (9.13±1.67) cm/s vs. (6.57±0.92) cm/s; t=9.1083 and 9.7030; both P<0.05]. There were no statistical differences in the incidences of CRT, mechanical phlebitis, and catheter displacement between the regular group and the routine group [1.89% (1/53) vs. 5.77% (3/52), 0 vs. 3.85% (2/52), and 0 vs. 1.92% (1/52); P=0.362 9, 0.242 9, and 0.495 2]. The exercise fatigue level during 12 days' catheter insertion in the regular group was better than that in the routine group (Z=2.574 7, P=0.005 0). Conclusion　Regular ball holding can improve the exercise fatigue of patients with hepatocellular carcinoma who are treated by chemotherapy and take PICC, adjust the axillary vein blood flow velocity, and reduce the incidences of CRT, mechanical phlebitis, and catheter displacement.

Key words:

Liver cancer, Ball holding methods, Axillary vein blood flow velocity, Exercise fatigue

摘要：

目的　探究不同握球方式对肝癌化疗经外周静脉置入中心静脉导管（peripherally inserted central catheter，PICC）患者腋静脉血流速度、导管相关性血栓（catheter-related thrombosis，CRT）预防效果及运动疲劳感的影响。方法　选取河南科技大学第一附属医院2020年10月至2022年11月河南科技大学第一附属医院收治的105例肝癌化疗PICC患者作为研究对象，依照握球方式将其分为常规组52例和规律组53例。常规组男27例，女25例，年龄（51.77±11.71）岁。规律组男29例，女24例，年龄（52.13±12.28）岁。常规组每天分3次握球500次左右；规律组每日三餐后握球25～30次，每次握紧10 s，松开10 s，握力大小以将握力球压缩至1/2为准。对比两组患者腋静脉血流速度，CRT、机械性静脉炎、导管移位发生情况，运动疲劳感。采用t检验、Fisher确切概率法、秩和检验。结果　置管4周后，规律组腋静脉最大流速、腋静脉单位时间内流速均高于常规组［（14.61±2.03）cm/s比（11.56±1.32）cm/s、（9.13±1.67）cm/s比（6.57±0.92）cm/s；t=9.108 3、9.703 0，均P<0.05］。规律组CRT、机械性静脉炎、导管移位发生率与常规组比较，差异均无统计学意义［1.89%（1/53）比5.77%（3/52）、0比3.85%（2/52）、0比1.92%（1/52）；P=0.362 9、0.242 9、0.495 2］。规律组置管12 d运动疲劳感水平优于常规组（Z=2.574 7，P=0.005 0）。结论　规律握球可改善肝癌化疗PICC患者运动疲劳感，调节腋静脉血流速度，降低CRT、机械性静脉炎、导管移位发生率。

关键词:

肝癌, 握球方式, 腋静脉血流速度, 运动疲劳感