肠内外营养结合针灸在术后胃瘫治疗中的疗效观察

发布时间：2018-11-20 11:37

【摘要】：目的:观察分析肠内外营养结合针灸在术后胃瘫治疗中的疗效。方法:收集并分析2005年1月至2016年10月因胃癌在皖南医学院第一附属医院行根治性胃大部切除术后并发胃瘫的患者资料,术后胃瘫患者按有无接受肠内外营养和针灸的治疗分为肠内营养结合针灸组(n=12)、肠外营养结合针灸组(n=9)和单纯肠内营养组(n=9)。比较三组患者术后住院天数和术后淋巴细胞计数、血红蛋白、总蛋白、白蛋白的差异。结果:肠内营养结合针灸组、肠外营养结合针灸组和单纯肠内营养组患者的术后住院天数分别为24.83±8.66d、35.78±11.69d、26.67±9.04d;三组间比较差异有统计学意义(p0.05),两两间比较显示:肠内营养结合针灸组和单纯肠内营养组患者术后住院天数均比肠外营养结合针灸组明显减少,差异有统计学意义(p0.05);肠内结合针灸组术后住院天数比单纯肠内营养组稍减少,但差异无统计学意义(p0.05)。术后1周三组患者的淋巴细胞计数、血红蛋白、总蛋白及白蛋白水平比较,差异无统计学意义,两组间比较差异也无统计学意义。术后2周肠内营养结合针灸组和单纯肠内营养组患者的白蛋白均比肠外营养结合针灸组明显增多,差异有统计学意义;此外,单纯肠内营养组术后2周的血红蛋白水平明显高于肠外营养结合针灸组。肠内营养结合针灸组患者术后2周的总蛋白和白蛋白比术后1周显著增多,差异有统计学意义;单纯肠内营养组患者术后2周的血红蛋白和白蛋白比术后1周明显增多,差异有统计学意义;而肠外营养结合针灸组患者术后第1周与术后2周的各项营养指标比较,差异无统计学意义。结论:肠内营养结合针灸及单纯肠内营养可明显改善术后胃瘫症状。肠内营养结合针灸与单纯肠内营养相比,术后住院天数的减少和营养状况的改善不明显。
[Abstract]:Objective: to observe and analyze the curative effect of enteral nutrition combined with acupuncture in the treatment of postoperative gastroparesis. Methods: data of patients with gastric cancer complicated with gastroparesis after radical subtotal gastrectomy in the first affiliated Hospital of Southern Anhui Medical College from January 2005 to October 2016 were collected and analyzed. Patients with postoperative gastroparesis were divided into three groups: enteral nutrition combined with acupuncture and moxibustion (n / 12), parenteral nutrition combined with acupuncture and moxibustion (n / 9) and simple enteral nutrition (n / 9). The differences of postoperative hospitalization days, lymphocyte count, hemoglobin, total protein and albumin were compared among the three groups. Results: the postoperative hospitalization days of patients in enteral nutrition combined with acupuncture group, parenteral nutrition combined with acupuncture group and simple enteral nutrition group were 24.83 卤8.66 days (35.78 卤11.69 days) and 26.67 卤9.04 days respectively. The difference among the three groups was statistically significant (p0.05). The results showed that the days of hospitalization in enteral nutrition combined with acupuncture group and simple enteral nutrition group were significantly lower than those in parenteral nutrition combined with acupuncture group. The difference was statistically significant (p0.05). The days of postoperative hospitalization in the combined enteral acupuncture group were slightly less than those in the simple enteral nutrition group, but the difference was not statistically significant (p0.05). There was no significant difference in lymphocyte count, hemoglobin, total protein and albumin levels between the two groups. Two weeks after operation, the albumin levels in the enteral nutrition combined with acupuncture group and simple enteral nutrition group were significantly higher than those in the parenteral nutrition combined with acupuncture group, and the difference was statistically significant. In addition, the hemoglobin level in simple enteral nutrition group was significantly higher than that in parenteral nutrition combined with acupuncture group 2 weeks after operation. The total protein and albumin in the group of enteral nutrition combined with acupuncture and moxibustion at 2 weeks after operation were significantly higher than that at 1 week after operation, and the difference was statistically significant. The levels of hemoglobin and albumin in simple enteral nutrition group at 2 weeks after operation were significantly higher than those at 1 week after operation, and the difference was statistically significant. However, there was no significant difference in nutritional indexes between the first week and the second week after operation in the group of parenteral nutrition combined with acupuncture and moxibustion. Conclusion: enteral nutrition combined with acupuncture and simple enteral nutrition can obviously improve the symptoms of postoperative gastroparesis. Compared with simple enteral nutrition, the days of hospitalization and the improvement of nutritional status were not obvious in the combination of enteral nutrition and acupuncture.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656

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