1 广东省中医院(广州中医药大学第二附属医院)大学城分院乳腺科，广州 510620
目的：探讨六步上肢锻炼操对经外周静脉穿刺中心静脉置管术(peripherally inserted central catheter，PICC)化学药物治疗(以下简称化疗)的乳腺癌患者导管相关性血栓(catheter-related thrombosis，CRT)发生率的影响。方法：将2017年9月至2018年8月在广东省中医院乳腺科经PICC化疗的151例乳腺癌患者随机分组，其中对照组(76例)采用常规握拳锻炼方案，观察组(75例)采用六步上肢锻炼操的方式进行锻炼，分别在置管后1周、4周、8周和12周对患者贵要静脉、锁骨下静脉、无名静脉及腋静脉进行彩超检查，比较两组患者CRT发生情况。结果：观察组患者在置管后第1周、第4周及总体CRT发生率均明显低于对照组，在置管后第8周和第12周时新发CRT发生率无明显差异；在已发生CRT患者中，对照组患者CRT官腔狭窄程度明显重于观察组(P<0.05)。结论：六步上肢锻炼操可有效降低乳腺癌化疗患者PICC CRT发生率。
Six-step upper limb exercises reduces the incidence of PICC catheter-related thrombosis in breast cancer patients undergoing chemotherapy
CorrespondingAuthor:WANG Ting WANG Ting
This work was supported by the Project of Guangdong Traditional Chinese Medicine Bureau, China (20131166).
Objective: To investigate the effect of six-step upper limb exercises on the incidence of catheter-related thrombosis (CRT) in breast cancer patients undergoing peripherally inserted central catheter (PICC) chemotherapy. Methods: A total of 151 breast cancer patients undergoing PICC chemotherapy in our department from September 2017 to April 2018 were randomly divided into two groups: 76 patients in the control group were given routine fist-clenching exercise, and 75 patients in the observation group were given six-step upper limb exercises. The basilic vein, subclavian vein, innominate vein and axillary vein were examined by color Doppler ultrasonography at 1 week, 4 weeks, 8 weeks and 12 weeks after catheterization. The incidence of thrombosis in the three groups was compared. Results: The incidence of CRT in the first week, the fourth week and the whole group of patients in the observation group was significantly lower than that in the control group. There was no significant difference in the incidence of new CRT in the eighth and twelfth weeks after catheterization. In patients with CRT, the stenosis degree of CRT in the control group was significantly higher than that in the observation group (P<0.05). Conclusion: Six-step upper limb exercises can effectively reduce the incidence of PICC catheter-related thrombosis in breast cancer patients undergoing chemotherapy, which is worthy of further promotion in clinical practice.
upper limb exercise; acupoint massage; breast cancer; peripherally inserted central catheter; catheter-related thrombosis