Preventive effects of hyperbaric oxygen combined with upper limb functional exercise on venous thrombosis in patients with PICC
10.3760/cma.j.cn311847-20210425-00129
- VernacularTitle:高压氧联合上肢功能锻炼对经外周置入中心静脉导管患者静脉血栓的预防作用
- Author:
Xuguang FENG
1
;
Chunhong ZHAO
1
;
Yong LEI
1
;
Changheng YIN
1
Author Information
1. 053000 河北省衡水，衡水市人民医院普外一科
- Publication Type:Journal Article
- Keywords:
Hyperbaric oxygen;
Upper limb functional exercise;
Peripherally inserted central catheter;
Venous thrombosis
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2021;28(6):767-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the preventive effects of hyperbaric oxygen combined with upper limb functional exercise on venous thrombosis in patients with peripherally inserted central catheter (PICC).Methods:A total of 144 patients with PICC admitted to the First Department of General Surgery of Hengshui People’s Hospital from December 2019 to June 2020 were retrospectively selected as the research subjects and divided into control group ( n=70) and observation group ( n=74) according to treatment methods. The control group was given upper limb functional exercise on the basis of conventional treatment, while the observation group was given hyperbaric oxygen treatment on the basis of the treatment of the control group. The incidences of venous thrombosis after treatment were compared between the two groups. The changes of coagulation and fibrinolytic functions and of hemorheology indicators of patients were detected before and after treatment. The predictive value of each indicator for the occurrence of venous thrombosis was evaluated by receiver operating characteristic (ROC) curve. Results:Compared with those before treatment, the prothrombin time (PT), the activated partial thromboplastin time (APTT), the thrombin time (TT), and the levels of tissue plasminogen activator (t-PA) in the two groups after treatment were significantly prolonged or increased, and the levels of fibrinogen (FIB), D-dimer, fibrinogen degradation product (FDP), and plasminogen activator inhibitor (PAI) in the two groups after treatment were significantly decreased ( P<0.05); compared with those in the control group after treatment, PT, APTT, TT, and the level of t-PA in the observation group after treatment were significantly prolonged or increased, and the levels of FIB, D-dimer, FDP, and PAI in the observation group after treatment were significantly lower; and all the differences were statistically significant ( P<0.05). Compared with those before treatment, the values of peak systolic velocity (PSV) and resistance index (RI) in the two groups after treatment were significantly lower, and the values of mean flow velocity (Vm) were significantly higher; compared with those in the control group after treatment, the values of PSV and RI in the observation group after treatment were significantly lower, and the value of Vm was significantly higher; and all the differences were statistically significant ( P<0.05). ROC curve analysis showed that the areas of FIB, D-dimer, FDP, and t-PA under the ROC curve predicting the occurrence of venous thrombosis were 0.823, 0.794, 0.684, and 0.787, respectively; the sensitivities were 75.0%, 66.7%, 61.2%, and 64.4%, respectively; the specificities were 81.5%, 83.3%, 74.6%, and 78.3%, respectively; and the accuracies were 74.3%, 72.6%, 68.4%, and 70.2%, respectively. The accuracy of FIB for the diagnosis of venous thrombosis was better than those of D-dimer, FDP, and t-PA. Conclusion:Hyperbaric oxygen combined with upper limb functional exercise can improve the coagulation function, fibrinolysis, and hemorheology of patients. Clinically, it can help predict the occurrence of venous thrombosis in upper limb by detecting the levels of FIB, D-dimer, FDP, and t-PA.
