International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (12): 1734-1739.DOI: 10.3760/cma.j.issn.1007-1245.2022.12.025

• Nursing Research • Previous Articles     Next Articles

Effects of ball grip exercise intensities of different metabolic equivalents on catheter complications and exercise fatigue after PICC catheterization

Dou Shoukun, Xia Guili,  Liu Zeqin, Wan Xin, Zhang Jing, Cheng Qing   

  1. Department of International Medicine, Shenzhen Hospital of Southern Medical University, Shenzhen 518000, China
  • Received:2021-12-27 Online:2022-06-15 Published:2022-06-27
  • Contact: Dou Shoukun, Email: doudou1978418@163.com

不同代谢当量的握球运动强度对PICC置管后导管并发症及运动疲劳感的影响

窦守坤  夏瑰丽  柳泽琴  万鑫  张静  程庆   

  1. 南方医科大学深圳医院国际医学部,深圳 518000

  • 通讯作者: 窦守坤,Email:doudou1978418@163.com

Abstract: Objective To explore the effects of ball grip exercise intensities of different metabolic equivalents (METs) on catheter complications and exercise fatigue after peripherally inserted central catheter (PICC). Methods From April 2020 to August 2021, 90 patients who underwent PICC in Shenzhen Hospital of Southern Medical University were randomly divided into 3 groups by the random number table method, with 30 cases in each group. The intensity of ball grip exercise was measured by MET the patientsin, the three groups were corresponded to exercise intensities of 1-2 METs, 2-3 METs, and 3-4 METs, the patients in the three groups wore sports watches showing exercise oxygen consumption when gripping the ball, and they all gripped the ball 300 groups every day, which were divided into 3 times within 2 h after three meals, 100 groups each time. The maximum blood flow velocity (Vmax) and minimum blood flow velocity (Vmin) of the axillary vein at rest state and 10 minutes after reaching the target exercise intensity were measured by color Doppler ultrasound on the 3rd day after the catheterization. The graded diagnosis of upper extremity venous thrombosis was completed by color Doppler ultrasound on the 7th and 14th day after catheterization. The incidence of other catheter complications (clogging, phlebitis, bleeding at the puncture point, and catheter displacement) within 14 days after PICC catheterization and patients' subjective fatigue after exercise 3-14 d after PICC catheterization were recorded. χ2 test or rank sum test were used for the count data, one-way ANOVA was used for comparison among three groups, LSD method was used for pial comparison, and independent sample t test was used for comparison between two groups. Results There were 17 males and 13 females in the 1-2 METs group, aged (54.60±10.45) years; there were 15 males and 15 females in the 2-3 METs group, aged (55.70±11.07) years; there were 18 males and 12 females in the 3-4 METs group, aged (55.25±10.93) years. The axillary vein Vmin and Vmax 10 minutes after reaching the target exercise intensity were significantly higher than those at rest state in the 1-2 METs, 2-3 METs, and 3-4 METs groups, with statistically significant differences (all P<0.05); there were no statistically significant differences in the axillary vein Vmin and Vmax among the three groups at rest state or 10 minutes after reaching the target exercise intensity (all P>0.05). There were no statistically significant differences in the incidence of upper limb venous thrombosis within 7 d and 14 d after catheterization among the three groups [10.00% (3/30) vs. 6.67% (2/30) vs. 6.67% (2/30), 20.00% (6/30) vs. 13.33% (4/30) vs. 10.00% (3/30)] (both P>0.05). There were no statistically significant differences in the incidences of clogging, phlebitis, bleeding at the puncture point, catheter displacement, and total complications among the three groups within 14 d after catheterization (all P>0.05). The proportion of exercise fatigue in the 1-2 METs group was lower than those in the 2-3 METs group and 3-4 METs group [26.67% (8/30) vs. 53.33% (16/30) vs. 76.67% (23/30)], with statistically significant differences (both P<0.05). Conclusions In patients with PICC catheterization, exercise intensities of 1-2 METs, 2-3 METs, and 3-4 METs have similar axillary vein blood flow velocity, incidence of upper limb venous thrombosis, and incidence of other catheter complications. Considering the exercise fatigue factor, the exercise intensity of 1-2 METs is suitable for ball grip exercise within 14 days after PICC catheterization.

Key words: Metabolic equivalent, Exercise intensity of ball grip, PICC, Axillary vein blood flow velocity, Upper extremity venous thrombosis, Catheter complications, Exercise fatigue

摘要: 目的 探讨不同代谢当量(MET)的握球运动强度对经外周静脉置入中心静脉导管(PICC)后导管并发症及运动疲劳感的影响。方法 研究类型为前瞻性随机对照研究,将2020年4月至2021年8月南方医科大学深圳医院行PICC置管90例患者按随机数字表法分为3组,每组30例;以MET衡量上肢握球运动强度,3组患者分别对应1~2 METs、2~3 METs、3~4 METs的运动强度,3组患者握球运动时均佩戴显示运动耗氧量的运动手表,均每日握球运动300组/d,三餐后2 h分3次开展,每次100组。PICC置管第3天采用多普勒彩色超声测量静息状态与达到目标运动强度运动10 min后的腋静脉最大血流速度(Vmax)与最小血流速度(Vmin),在置管第7天、置管第14天采用多普勒彩色超声完成上肢静脉血栓分级诊断;并记录PICC置管14 d内导管其他并发症发生率(堵管、静脉炎、穿刺点出血、导管移位)及PICC置管3~14 d患者运动后的主观疲劳感。计数资料采用χ2检验或秩和检验;计量资料3组间比较采用单因素方差分析(One-way ANOVA),两两比较采用LSD法,两组间比较采用独立样本t检验。结果 1~2 METs组男17例、女13例,年龄(54.60±10.45)岁;2~3 METs组男15例、女15例,年龄(55.70±11.07)岁;3~4 METs组男18例、女12例,年龄(55.25±10.93)岁。1~2 METs、2~3 METs、3~4 METs组患者运动达标10 min后的腋静脉Vmin、Vmax均显著高于同组静息状态下的Vmin、Vmax,差异均有统计学意义(均P<0.05);3组患者静息状态下与运动达标10 min后的腋静脉Vmin、Vmax比较差异均无统计学意义(均P>0.05)。3组患者置管7 d、14 d内的上肢静脉血栓发生率比较差异均无统计学意义[10.00%(3/30)比6.67%(2/30)比6.67%(2/30),20.00%(6/30)比13.33%(4/30)比10.00%(3/30)](均P>0.05)。3组患者置管14 d内堵管、静脉炎、穿刺点出血、导管移位及总并发症发生率比较差异均无统计学意义(均P>0.05)。1~2 METs组运动疲劳感比例低于2~3 METs组及3~4 METs组[26.67%(8/30)比53.33%(16/30)比76.67%(23/30)],差异均有统计学意义(均P<0.05)。结论 1~2 METs、2~3 METs、3~4 METs运动强度下的PICC置管患者腋静脉血流速度、上肢静脉血栓发生率及其他导管并发症发生率相当,考虑运动疲劳因素,1~2 METs的运动强度适宜作为PICC置管14 d内的握球运动强度。

关键词: 代谢当量, 握球运动强度, PICC, 腋静脉血液流速, 上肢静脉血栓, 导管并发症, 运动疲劳感