Abstract:

Objective To investigate the effects of continuous ball holding on hemodynamics of upper limb axillary vein in cancer patients with PICCs, to provide scientific basis for ball holding exercise.Methods Eighty-five cancer patients after PICC catheterization were randomly selected from oncology department at a tertiary hospital in Beijing. Using before-after study design, we recorded the changes of venous vessel diameter, blood flow velocity and blood pressure with different ball holding duration under ultrasonic monitoring.Results In the resting state, the diameter of venous vessel was（3.98±0.66） mm, the peak velocity of blood flow was（13.49±4.92） cm/s, and the pressure of blood vessels was（0.06±0.04） mmHg. Compared with the resting state, the duration of ball holding had statistically significant impact on diameter, peak velocity and pressure of venous vessels（P<0.05）, which were all higher than the resting state. The diameter of the blood vessel was the largest when holding for 1s and releasing for 1s（4.36±0.68） mm, the maximum blood flow velocity（23.17±7.09） cm/s and the maximum blood pressure （0.17±0.13） mmHg occurred when holding for 2s and releasing for 2s.Conclusion Ball holding exercises can effectively enlarge the diameter of vein, increase blood flow velocity and muscle pressure on the vascular wall. We can guide cancer patients with PICCs to exercise according to the method of holding for 2s and releasing for 2s. The method is simple and feasible, and does not cause discomfort to the patients, which can be widely used in clinical practice.

Key words: Holding Duration, Peripherally Inserted Central Catheter, Catheterization, Central Venous

摘要：

【目的】探讨不同握球持续时间对PICC置管肿瘤患者的上肢腋静脉血液流速的影响。【方法】在北京市某三级甲等医院肿瘤内科随机选取符合标准的85例PICC置管肿瘤患者,采用自身前后对照的方法在超声监测下记录不同握球持续时间对静脉血管直径、血流速度和血管压力的影响。【结果】患者在静息状态下的静脉血管直径为（3.98±0.66） mm、血流峰速度为（13.49±4.92） cm/s、血管压力为（0.06±0.04） mmHg（1 mmHg=0.133 kPa）。与静息状态相比,不同握球持续时间下静脉血管直径、血流峰速度和血管压力比较,差异均有统计学意义（P<0.05）,且均高于静息状态（P<0.05）。其中握1 s松1 s时静脉血管直径最大（4.36±0.68） mm,握2 s松2 s时血流峰速度最大（23.17±7.09） cm/s、血管压力最大（0.17±0.13） mmHg。【结论】握球锻炼可有效扩大静脉直径、增加血流速度和肌肉对血管壁的压力。指导PICC置管的肿瘤患者在握球时按照握2 s松2 s的方法进行锻炼,简单可行且未引起患者不适,该方法可在临床中应用。

关键词: 握球时间, 经外周穿刺中心静脉导管, 导管插入术, 中心静脉