以质量求发展,以服务铸品牌

Journal of Nursing ›› 2019, Vol. 26 ›› Issue (1): 8-11.doi: 10.16460/j.issn1008-9969.2019.01.008

Previous Articles     Next Articles

Effect of grip strength on axillary venous hemodynamics in tumor patients with PICC

DAI Feng1, SU Xun1, WANG Lei2, WANG Jun2, REN Xing-hua2   

  1. 1. Clinical Medical College of Air Force, Anhui Medical University, Hefei 230032,China;
    2. Dept. of Nursing Administration, Air Force Medical Center, PLA, Beijing 100142, China
  • Received:2018-09-22 Online:2019-01-10 Published:2020-07-16

Abstract: Objective To discuss the influence of grip strength on hemodynamics of upper limb veins after the implantation of PICC in patients with tumors and to provide scientific basis for the exercise of holding the ball. Methods We conducted prospective clinical observation and 40 patients with PICC catheter implanted in a tertiary grade A hospital in Beijing from July to August 2018 were selected. Patients performed with gripper to measure grip strength by self contrast method, and the effects of grip force on venous vessel diameter, blood flow velocity and blood pressure were observed by ultrasound. Results In rest state, the vessel diameter of venous blood flow was (4.18±0.83) mm; the peak velocity was(12.39±3.17) cm/s and the pressure of vein to vessel wall was(0.06±0.03) mmHg. There was no significant difference in vessel diameter with different grip strength (P>0.05) but there was in peak velocity and pressure of blood flow (P<0.05). The changes of venous hemodynamics with different grip strength were statistically significant. The peak velocity and pressure of venous blood flow after using 80% maximum grip strength (MGS), 90% MGS and 100% MGS were significantly different from those in rest state (P<0.05). Conclusion Gripping force can effectively increase venous blood flow velocity and venous pressure on the vascular wall, but it does not cause discomfort to patients. It can be used to guide clinical patients with PICC for functional exercise. The pressure of 80% MGS-100% MGS is the most suitable grip strength, which can be promoted in clinical practice.

Key words: tumor patient, PICC, grip strength, hemodynamics, clinical research

CLC Number: 

  • R473.73
[1] Lyman G H, Khorana A A, Kuderer N M, et al.Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: American Society of Clinical Oncology clinical practice guideline update[J]. J Clin Oncol, 2013, 31(17):2189-2204. DOI:10.1200/JCO.2013.49.1118.
[2] Chopra V, Anand S, Krein S L, et al.Bloodstream Infection, Venous Thrombosis, and Peripherally Inserted Central Cathe-ters: Reappraising the Evidence[J]. Am J Med, 2012,125(8):733-741. DOI:10.1016/j.amjmed.2012.04.010.
[3] 张建薇,傅荣. 握拳运动在预防老年PICC置管患者上肢深静脉血栓中的应用效果[J].中华现代护理杂志,2018,24(4):440-442.DOI:10.3760/cma.j.issn.1674-2907.2018.04.016.
[4] 惠慧,马燕兰,郭艳艳,等. 不同握球运动还是对PICC置管患者静脉血流及相关性血栓的影响[J].中华现代护理杂志,2018,24(12):1391-1398.DOI:10.3760/cma.j.issn.1674-2907.2018.12.008.
[5] 周晔. 不同频次的握拳运动对PICC相关性血栓的影响[D].南京:南京医科大学,2015.
[6] 江小好,卓雅淑,蒋静婷.海绵球锻炼预防PICC致机械性静脉炎的临床效果[J].实用医学杂志,2015, 31(5):844-846.DOI:10.3969/j.issn.1006-5725.2015.05.051.
[7] 伦雪萍,陈慕瑶,周海燕,等.上肢运动操在预防PICC置管患者并发静脉血栓中的应用[J].临床医药文献电子杂志,2014,1(6):966. DOI:10.16281/j.cnki.jocml.2014.06.049.
[8] 曹轶,马俊,金燕萍.湿热敷联合使用握力器降低经外周静脉穿刺中心静脉置管致机械性静脉炎的发生[J]. 解放军护理杂志,2015, 32(11):55-57.DOI:10.3969/j.issn.1008-9993.2015.11.017.
[9] 王敏. 主动握拳活动对预防PICC相关上肢静脉血栓形成的效果[J].护理实践与研究,2016,13(22):141-142. DOI:10.3969/j.issn.1672-9676.2016.22.058.
[10] Fess E, Moran C.Clinical Assessment Recommendations[M]. Philadelphia: American Society of Hand Therapists Monograph,1981.
[11] Helen C R, Hayley J D, Helen J M, et al.A review of the Measurement of Grip Strength in Clinical and Epidemiological Studies: towards a Standardised Approach[J]. Age and Ageing,2011,40(4):423-429.DOI:org/10.1093/ageing/afr051.
[12] Cooper R, Kuh D, Cooper C, et al.Objective Measures of Physical Capability and Subsequent Health: A Systematic Review[J]. Age Ageing, 2011,40(1):14-23. DOI:10.1093/ageing/afq117.
[13] Hebert L E, Scherr P A, McCann J J, et al. Change in Direct Measures of Physical Performance among Persons with Alzheimer's Disease[J]. Aging Ment Health, 2008,12(6):729-734. DOI:10.1080/13607860802154390.
[14] Cawthon P M, Fullman R L, Marshall L, et al.Physical Performance and Risk of Hip Fractures in Older Men[J]. J Bone Miner Res,2008, 23(7):1037-1044.DOI:10.1359/jbmr.080227.
[15] Sirola J, Rikkonen T, Tuppurainen M, et al.Grip Strength may Facilitate Fracture Prediction in Perimenopausal Women with Normal BMD: A 15-year Population-based Study[J]. Calcif Tissue Int,2008,83(2):93-100. DOI:10.1007/s00223-008-9155-0.
[16] Cooper R, Kuh D, Hardy R.Objectively Measured Physical Capability Levels and Mortality: Systematic Review and Meta-analysis[J]. BMJ,2010,341:c4467.DOI:10.1136/bmj.c4467.
[17] Sasaki H, Kasagi F, Yamada M, et al.Grip Strength Predicts Cause-specific Mortality in Middle-aged and Elderly Persons[J].Am J Med,2007,120(4):337-342.DOI:10.1016/j.amjmed.2006.04.018.
[18] Liu K, Zhou Y, Xie W, et al.Handgrip Exercise Reduces Peripherally-inserted Central Catheter-related Venous Thrombosis in Patients with Solid Cancers: A Randomized Controlled Trial[J]. Int J Nurs Stud,2018,86:99-106.DOI: org/10.1016/j.ijnurstu.2018.06.004.
[19] Nifong T P, McDevitt T J. The Effect of Catheter to Vein ratio on Blood Flow Rates in a Simulated Model of Peripherally Inserted Central Venous Catheters[J]. Chest, 2011,140(1):48-53. DOI:10.1378/chest.10-2637.
[1] LU Ting, YING Yan-ping, ZHAO Hui-han, LI Qian, XU Yi, LING Yin. Influence Factors of Handgrip Strength in Patients with Malignant Tumors [J]. Journal of Nursing, 2020, 27(6): 1-4.
[2] WANG Qin, CHEN Jin, WEI Li. Cohort Study on Influence Factors of Medical Adhesive-related Skin Injury in PICC Insertion Site of Tumor Patients [J]. Journal of Nursing, 2019, 26(17): 1-5.
[3] ZHAO Bing-yuan, LIU Feng, JIANG Gui-chun, MAO Meng-ting, XIAO Li-ping. Current Status of Severity of Opioid-related Constipation in Cancer Patients and Its influence Factors [J]. Journal of Nursing, 2019, 26(11): 9-14.
[4] TIAN Ting, HUANG Rui-na, QI Yi, ZHOU Ya-juan, HAN Hui, LIU Wan-jun, HE Hai-xia, WU Xiao-wan. Risk Factors of PICC-related Venous Thrombosis in Cancer Patients: A Meta-analysis [J]. Journal of Nursing, 2019, 26(11): 49-54.
[5] CHEN Meng-jin,LI Hai-xiang,HUANG Chun-xiang,YAO Xiong,WANG Xi-ying,YANG Jie-wei. Effect of Peer Education on Self-management and Complication of Cancer Patients with PICC [J]. Journal of Nursing, 2018, 25(8): 75-78.
[6] WANG Chun-li, CUI Jie, ZHEN Ying-zi, DING Ya-guang, ZHANG Yu-ling, YE Jing. Complications in 161 Children PICC Maintenance Clinic and Its Nursing [J]. Journal of Nursing, 2018, 25(22): 62-64.
[7] DU Yan-ming,WANG Bei,WANG Shui. Effects of Physical Exercises on Preventing PICC Catheter Blockage in Patients with Breast Cancer [J]. Journal of Nursing, 2017, 24(8): 35-37.
[8] SHEN Yan ,ZHU Hai-xia ,PENG Kai-zhen ,ZHOU Yu-feng . Effect of Gelatin Sponge on PICC-inducted Contact Dermatitis in Children [J]. Journal of Nursing, 2017, 24(8): 37-39.
[9] GUO Ling,QIN Ying,LIAO Li,GAO Li,YU Qi-yan,JIANG Qun. Effect of Electrocardiography Combined with B-ultrasound in Prevention of PICC Tip Malposition [J]. Journal of Nursing, 2017, 24(23): 67-70.
[10] GONG Ping,LIU Jian-hong,MENG Ai-feng,WU Bing. Effects of QQ-based Health Education for Patients with PICC at Home [J]. Journal of Nursing, 2017, 24(23): 71-75.
[11] WANG Bin,HUANG Xia,WANG Hong-mei. Development of Nursing Sensitive Outcome Index for Patients with PICC [J]. Journal of Nursing, 2017, 24(19): 5-9.
[12] MO Zhang-yang,TAN Hong-hong,MO Qin-guo,MAO Chuan-lan,HE Ying-yu,WEI Yu-qun,PANG Yong-hui. Effect of Ginger Separated Moxibustion with Happpall on Recovery of Affected Upper-arm after Radical Mastectomy [J]. Journal of Nursing, 2017, 24(14): 5-8.
[13] SONG Jian,WANG Chun-lin,HU Jun-e. Effect of Atrial Electrogram on PICC Catheter Tip Location:A Meta Analysis [J]. Journal of Nursing, 2017, 24(13): 14-18.
[14] WU Wan-ying,YANG Fang-ying,GAO Li-qin,WANG Hui-qin,JIANG Zi-fang. Nursing Consultation on Difficult Problems in Venous Access for Tumor Patients [J]. , 2016, 23(9): 60-62.
[15] REN Xiu-qin,WU Xian-cui,XU Li,GU Dong-ying. Influence Factors of PICC Catheter Blockage of Cancer Patients during Treatment Period and Its Nursing Strategy [J]. , 2016, 23(3): 43-46,47.
Viewed
Full text


Abstract

Cited

  Shared   
[1] . [J]. Journal of Nursing, 2019, 26(7): 61 -64 .
[2] . [J]. Journal of Nursing, 2019, 26(7): 65 -69 .
[3] . [J]. Journal of Nursing, 2019, 26(7): 70 -73 .
[4] . [J]. Journal of Nursing, 2019, 26(7): 74 -76 .
[5] . [J]. Journal of Nursing, 2019, 26(7): 77 -78 .
[6] ZHOU Ying, LU Hong-zhou, ZHANG Lin, SUN Mei-yan. Experience of Male HIV/AIDS Patients with Case Management in Clinic: A Qualitative Study[J]. Journal of Nursing, 2020, 27(10): 1 -4 .
[7] HUANG Ying-ying, CAO Wei-ping, WEI Jia-jie, LI Yan. Qualitative Study on Illness Experiences of Hypertensive Disorders in Pregnancy[J]. Journal of Nursing, 2020, 27(10): 5 -9 .
[8] CHEN Zhi-lan, MA Li-li , YANG Hui-min , LI Chun-xiang. Effect of Small-scale Restricted Blended Teaching Using Rain Classroom in Basic Nursing for Nursing Undergraduates[J]. Journal of Nursing, 2020, 27(10): 10 -13 .
[9] . [J]. Journal of Nursing, 2020, 27(10): 14 -18 .
[10] YAN Dan-dan, CAI Xun, LIU Qin. Influence of CDIO Teaching Mode on Diabetes Management Knowledge, Attitude to Online Learning of Clinical Nurses[J]. Journal of Nursing, 2020, 27(10): 19 -22 .