Abstract:

Objective To compare the effects of bilateral ball-squeezing exercise and unilateral （catheter-side） ball-squeezing exercise in patients with peripherally inserted central catheter（PICC） placement，so as to provide evidence for clinical practice. Methods Convenience sampling was used to recruit PICC patients admitted to a tertiary hospital in Zhejiang Province from May to December 2023. Participants were randomly assigned into an experimental group and a control group using a random number table. The experimental group performed bilateral ball-squeezing exercise，while the control group performed unilateral ball-squeezing exercise with the catheter-side limb. The incidence of catheter-related thrombosis，hemodynamics of the axillary vein on the catheter side，exercise compliance，and the incidence of other catheter-related complications were compared between the 2 groups. Results A total of 222 patients completed the study，including 113 in the experimental group and 109 in the control group. The incidence of catheter-related thrombosis was significantly lower in the experimental group than it in the control group（P=0.024）. On days 21 and 28 after catheterization，the venous blood flow velocity and flow volume in the experimental group were significantly higher than those in the control group（P<0.05）. Exercise compliance was significantly better in the experimental group than it in the control group（P=0.002）. The incidence of other catheter-related complications showed no significant difference between the 2 groups（P=0.629）. Conclusion Bilateral ball-squeezing exercise can reduce the incidence of catheter-related thrombosis，increase venous blood flow velocity and flow volume in the axillary vein on the catheter side，and improve patients’ exercise compliance，without increasing the risk of other catheter-related complications.

Key words: Peripherally Inserted Central Catheter, Functional Exercise, Ball-Squeezing, Thrombus, Blood Flow Velocity, Nursing Care

摘要：

目的 比较PICC置管患者双手及置管侧单手握球锻炼的效果，以指导临床实践。 方法 采用便利抽样法，选取2023年5—12月浙江省某三级甲等医院收治的PICC置管患者作为研究对象，采用随机数字表法将其分为试验组、对照组。试验组进行双手握球锻炼，对照组进行PICC置管侧单手握球锻炼。比较两组导管相关性血栓发生率、置管侧腋静脉血流动力学、握球锻炼依从性以及其他导管相关并发症发生率。 结果 共222例患者完成研究，其中试验组113例、对照组109例。研究结果显示，试验组导管相关性血栓发生率低于对照组，差异具有统计学意义（P=0.024）；置管后第21、28天，试验组的置管侧腋静脉血流速度快于对照组、血流量高于对照组，差异具有统计学意义（P<0.05）；试验组握球锻炼依从性高于对照组，差异具有统计学意义（P=0.002）；两组其他导管相关并发症发生率比较，差异无统计学意义（P=0.629）。 结论 采用双手握球锻炼有助于降低导管相关性血栓发生率，增加置管侧腋静脉的血流速度和血流量，提高患者的握球锻炼依从性，且不会增加其他导管相关并发症的发生率。

关键词: 经外周置入中心静脉导管, 功能锻炼, 握球, 血栓, 血液流速, 护理