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太极拳对化疗间歇期 PICC 肿瘤患者导管管理和生活质量的影响:一项非劣效性随机对照试验。

Effects of tai chi on catheter management and quality of life in tumor patients with PICC at the intermission of chemotherapy: a non-inferiority randomized controlled trial.

机构信息

Department of PICC clinic, Hai'an People's Hospital, Hai'an, China.

Department of Breast and Thyroid Surgery, Jiangyin People's Hospital, Jiangyin, China.

出版信息

Ann Palliat Med. 2020 Sep;9(5):3293-3303. doi: 10.21037/apm-20-1456. Epub 2020 Sep 2.

Abstract

BACKGROUND

Peripherally inserted central catheter (PICC) is widely used in chemotherapy due to its minimal complications and simple wound care. This study explored the effects of tai chi on catheterrelated complications, catheter management ability, and quality of life in tumor patients with PICC at the intermission of chemotherapy.

METHODS

This study was an open parallel trial. A total of 98 patients with malignant tumors who underwent long-term chemotherapy with PICC were randomly divided into an observation group (49 cases) and a control group (49 cases). The control group received grip strength exercise for 3 months, while the observation group received 24 simplified tai chi exercises. The coagulation function, thrombosis rate, self-management ability, and quality of life were compared between the two groups before and after the intervention.

RESULTS

After the intervention, the activated partial thromboplastin time (APTT) and prothrombin time (PT) in the observation group were longer than those in the control group, while fibrinogen (FIB) was lower than that in the control group (all P<0.05). After the intervention, the total score of self-management ability of the observation group was higher than that of the control group (t=2.038, P=0.047), and the scores of exercises ability and quality of daily life with catheters were significantly increased (all P<0.05). In terms of quality of life, scores of role-physical (RP), social functioning (SF), mental health (MH) and role-emotional (RE) in the observation group were higher than those in the control group (all P<0.05), while there was no statistical difference between the bodily pain (BP) scores of the observation group and the control group (P>0.05). The incidence of venous thrombosis in the observation group was lower than that in the control group, the difference was statistically significant ( χ 2 =4.439, P=0.035).

CONCLUSIONS

Tai chi can prevent PICC thrombosis, reduce PICC-related complications, improve selfmanagement ability, and improve quality of life in at-home patients with long-term PICC.

摘要

背景

经外周静脉置入中心静脉导管(PICC)因其并发症少、伤口护理简单而广泛应用于化疗。本研究旨在探讨化疗间歇期行太极运动对 PICC 肿瘤患者导管相关性并发症、导管管理能力和生活质量的影响。

方法

这是一项开放平行试验。共纳入 98 例接受 PICC 行长期化疗的恶性肿瘤患者,随机分为观察组(49 例)和对照组(49 例)。对照组接受握力锻炼 3 个月,观察组接受 24 式简化太极拳锻炼。比较两组患者干预前后凝血功能、血栓发生率、自我管理能力和生活质量。

结果

干预后,观察组的活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)长于对照组,纤维蛋白原(FIB)低于对照组(均 P<0.05)。干预后,观察组自我管理能力总分高于对照组(t=2.038,P=0.047),锻炼能力和导管日常生活质量评分均明显升高(均 P<0.05)。在生活质量方面,观察组角色躯体(RP)、社会功能(SF)、心理健康(MH)和角色情绪(RE)评分高于对照组(均 P<0.05),而躯体疼痛(BP)评分与对照组比较差异无统计学意义(P>0.05)。观察组静脉血栓发生率低于对照组,差异有统计学意义( χ 2 =4.439,P=0.035)。

结论

太极运动可以预防 PICC 血栓形成,减少 PICC 相关性并发症,提高患者自我管理能力,改善长期 PICC 患者的生活质量。

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