耳穴压丸法治疗胸腰椎骨折术后腹胀便秘效果研究

发布时间：2018-04-13 01:03

本文选题：耳穴压丸法 + 胸腰椎骨折术后　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：观察利用椎弓根螺钉固定技术治疗脊柱胸腰段骨折,术后患者腹胀便秘的发生及恢复情况。采用耳穴压丸法干预,观察该法治疗胸腰椎骨折术后腹胀便秘的疗效,以期扩大耳穴压丸法的治疗范围。方法：收集2015年1月至2016年1月因胸腰椎骨折于四川省骨科医院脊柱科行经后路椎弓根螺钉内固定术的患者共80例,利用计算机生成的随机数字法将80例患者随机分成A、B两组,每组40人。A组为治疗组,在术后常规护理(包括饮食指导、心理疏通、腹部按摩等)的基础上,加用耳穴压丸法(穴位选取大肠、直肠、小肠、三焦、内分泌、胃、脾、肾)进行干预2周。B组为对照组,单纯采用常规护理。分别记录两组患者术后肛门首次排气(h)、排便时间(d)术前及术后6个时间点(第2天、3天、5天、7天、2周、1月)腹胀便秘积分情况。利用SPSS20.0对采集收据进行整理、分析,得出结论。结果：A组(治疗组)患者术后首次排气时间平均27.4±4.8h,首次排便时间平均2.7±0.7天；B组(对照组)患者首次排气时间平均37.8±4.6h,首次排便时间平均3.7±0.8天。治疗组首次排气、排便时间均明显早于对照组,具有统计学意义(P0.05)。治疗组在耳穴干预期间(术后2周内)各时间点腹胀便秘积分明显低于对照组,峰值小于对照组,且能够较快恢复至术前水平,各项指标表明术后胃肠功能恢复均明显优于对照组。A组共有痊愈11例(28.9%),显效16例(42.1%),有效8例(21.1%),无效3例(9%),总有效率92.1%。B组患者共有痊愈5例(13.2%),显效7例(18.4%),有效12例(31.6%),无效14例(36.8%),总有效率63.2%。A组总有效率明显高于B组,经秩和检验,具有统计学意义(P0.05)。术后1月随访发现两组患者腹胀便秘积分无明显差异(P0.05)。两组患者首次排气时间、排便时间随年龄增长逐渐延长,经单因素方差分析具有统计学意义(P0.05)。术后各观察时间点腹胀便秘积分随年龄增长而增加,经多因素方差分析,具有统计学意义(P0.05)。结论：1、耳穴压丸法能够有效降低胸腰椎骨折患者术后腹胀便秘的发生程度,促使胃肠功能尽快恢复至正常水平。2、患者在基本护理条件下胃肠功能可以自行恢复至正常水平,但恢复周期较长。3、年龄是影响胸腰椎骨折患者术后腹胀便秘发生和恢复的一个重要因素。
[Abstract]:Objective: to observe the occurrence and recovery of abdominal distention constipation after spinal thoracolumbar fracture treated by pedicle screw fixation.The treatment of abdominal distention and constipation after thoracolumbar vertebra fracture was observed by using auricular acupoint pressing pill method in order to expand the treatment range of auricular acupoint compression pill.Methods: from January 2015 to January 2016, 80 patients with thoracolumbar fractures underwent posterior pedicle screw fixation in the Department of Spine, Sichuan Orthopaedic Hospital, and 80 patients were randomly divided into two groups by computer generated random number method.Group A (40 persons in each group), on the basis of routine nursing care (including diet guidance, psychological dredging, abdominal massage, etc.), was treated with auricular acupoint pressing pills (acupoint selection of large intestine, rectum, small intestine, tri-Jiao, endocrine, stomach, spleen, etc.)Group B was taken as control group for 2 weeks, and routine nursing was used only.The scores of abdominal distention and constipation were recorded at 6 time points before and after operation (day 2: 3 days, 5 days, 7 days, 2 weeks, 1 month).Use SPSS20.0 to collect the receipt to carry on the arrangement, analysis, draw the conclusion.Results the mean first exhaust time was 27.4 卤4.8 hours, the first defecation time was 2.7 卤0.7 days in group B (control group) was 37.8 卤4.6 hours, and the first defecation time was 3.7 卤0.8 days.The first exhaust and defecation time in the treatment group were significantly earlier than those in the control group (P 0.05).The score of abdominal distention constipation in the treatment group was significantly lower than that in the control group at each time point during the auricular point intervention (within 2 weeks after operation), and the peak value was lower than that in the control group, and it could recover quickly to the preoperative level.The total effective rate of group A was significantly higher than that of group B, and the total effective rate of group A was significantly higher than that of group B.By rank sum test, there was statistical significance (P 0.05).1 month follow-up showed that there was no significant difference in abdominal distension and constipation score between the two groups (P 0.05).The first exhaust time and defecation time of the two groups were prolonged with the increase of age, and there was significant difference between the two groups by univariate ANOVA (P 0.05).The score of abdominal distension and constipation increased with age at different time points after operation, and it was statistically significant by multivariate analysis of variance (P 0.05).Conclusion the ear point pressing pill method can effectively reduce the incidence of abdominal distention and constipation in patients with thoracolumbar fracture, and promote the recovery of gastrointestinal function to normal level as soon as possible. The gastrointestinal function of patients can recover to normal level by themselves under the basic nursing condition.But the recovery period is long. 3. Age is an important factor to influence the occurrence and recovery of abdominal distention constipation after thoracolumbar fracture.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.2

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