肩部活动操在植入手臂输液港患者中的应用研究

doi:10.3761/j.issn.0254-1769.2021.05.011

摘要/Abstract

摘要：

目的评价肩部活动操在植入手臂输液港患者中的应用效果。方法采用便利抽样法,选取2019年10月 —12月在郑州市某三级甲等医院肿瘤科住院、植入手臂输液港且肩关节活动受限的116例患者作为研究对象,采用随机数字表法,将其分为试验组59例和对照组57例。试验组进行肩部活动操锻炼,对照组进行握球运动锻炼,锻炼时长均为3个月。比较两组锻炼后肩关节功能评价量表得分,锻炼第1个月、第2个月、第3个月及锻炼期间血栓和导管阻塞发生率。结果锻炼后试验组肩关节功能评价量表中肩关节活动范围、日常生活活动能力、肌力评分高于对照组,差异具有统计学意义（P<0.05）;锻炼第1个月,试验组血栓及导管阻塞发生率低于对照组,差异具有统计学意义（P<0.05）;锻炼期间,试验组血栓及导管阻塞总发生率低于对照组,差异具有统计学意义（P<0.05）。结论肩部活动操锻炼有助于改善植入手臂输液港患者肩关节活动受限,降低其血栓和导管阻塞发生率。

关键词: 肩, 运动, 血栓, 导管阻塞, 中心静脉导管, 护理

Abstract:

Objective To observe and evaluate the effect of self-designed shoulder exercise in patients with limited shoulder joint movement after the implantation of an arm infusion port.Methods 116 inpatients with limited shoulder joint movement after the implantation of the arm port were selected by oncology nurses of a tertiary hospital using convenience sampling method from October to December 2019. By the random number table method,the patients were randomly divided into an experimental group（59 cases）and a control group（57 cases）. The experimental group received shoulder exercise for 3 months,while the control group received ball gripping exercise for the same time period. The total score of shoulder joint function,the score of each sub-group,the occurrence of thrombus and tube blockage in the arm infusion port were compared between the 2 groups before and after the exercise for 3 months.Results 3 months after the exercise,there was no statistically significant difference between the experimental group and the control group in the total scores before the exercise（P>0.05）,while there was statistically significant difference in the total scores after the exercise（P<0.05）. The shoulder joint movement,activity ability of daily life and muscle strength scores in the experimental group were higher than those in the control group with statistically significant differences（P<0.05）. A month after the exercise,the incidences of catheter-related thrombosis and tube blockage in the experimental group were lower than those in the control group,and the differences between the 2 groups were statistically significant（P<0.05）. During the whole exercise period,the total incidence of catheter-related thrombosis and blockage in the experimental group was lower than it in the control group with statistically significant differences（P<0.05）.Conclusion Shoulder joint exercise is helpful to improve the limitation of shoulder joint movement in patients with the arm infusion port,to reduce the incidences of thrombus and blockage of the arm infusion port,and it is worthy of clinical promotion.

Key words: Shoulder, Exercise, Thrombosis, Catheter Obstruction, Central Venous Catheters, Nursing Care

张素兰,刘倩倩,王佳琪,单唱,赵娟,梁丽,王小雨,李醒亚. 肩部活动操在植入手臂输液港患者中的应用研究[J]. 中华护理杂志, 2021, 56(5): 710-715.

ZHANG Sulan,LIU Qianqian,WANG Jiaqi,SHAN Chang,ZHAO Juan,LIANG Li,WANG Xiaoyu,LI Xingya. Evaluation of the application effect of shoulder joint exercise in patients with limited shoulder joint movement after implantation of arm infusion port[J]. Chinese Journal of Nursing, 2021, 56(5): 710-715.

图/表 3

表1 两组一般资料比较

Table 1 Comparison of general data between the two groups

表2 锻炼前后两组肩关节功能评价量表得分比较（分,$\bar{x}$±s）

Table 2 Comparison score of shoulder joint function rating scale before and after exercise between the two groups（scores,$\bar{x}$±s）

表3 锻炼后两组血栓及导管阻塞发生率比较[例（百分率,%）]

Table 3 Comparison of the incidence of armport thrombosis and catheter occlusion between the two groups at different time points[cases,percentage（%）]

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