胃肠外科术后肛门排气延迟患者不同中医护理干预方法的效果比较

发布时间：2018-06-07 19:59

本文选题：胃肠外科术 + 肛门排气延迟　；参考：《四川中医》2017年04期

【摘要】：目的:比较不同中医方法对胃肠外科术后肛门排气延迟患者的干预效果。方法:收集我院2014年4月2015年8月期间行胃肠外科手术的94例患者,术后均伴有肛门排气延迟(3d)症状。抽签随机分为3组并给予不同干预手段,其中对照组30例仅给予术后病情监护、切口清洁处理等常规护理干预;中医干预1组32例术后在对照组基础上给予温水足浴按摩法,浸泡25min/次,3次/d,浸泡时在足底穴位按摩。中药干预2组32例术后在对照组基础上给予小茴香热敷结合针灸疗法干预,30min/次,2次/d;均持续干预5d后,观察3组干预方法对肛门排气延迟患者胃肠动力学[胃动素(MTL)、胃泌素(GAS)、五羟色胺(5—HT)]的影响,记录两组腹胀腹痛、恶心呕吐、低热等相关胃肠道症状发生情况,比较干预后3组肛门排气时间、排便时间以及干预前后视觉模拟疼痛(VAS)、生活质量(SF—36)变化。结果:(1)胃动力学方面:中医干预1、2组干预后MTL、GAS、5—HT较干预前均有明显改善,且MTL、5—HT优于对照组,均差异显著(P0.05),但二组相较无显著差异(P0.05);(2)胃肠道症状:中医干预1、2组相较对照组均能降低胃肠道不良症状发生率,差异显著(P0.05),但二者相较无显著差异(P0.05);(3)排气、排便方面:中医干预1、2组肛门排气、排便时间均低于对照组,差异显著(P0.05),但二者相较无显著差异(P0.05);(4)VAS、SF—36方面:中医1、2组干预后VAS较对照组低,SF—36较对照组高,均差异显著(P0.05),但中医2组VAS较中医1组低,差异显著(P0.05)。结论:1对胃肠外科术后肛门排气延迟患者采用小茴香热敷结合针灸疗法、温水足浴按摩干预方法均能有效改善胃肠动力、促进胃肠蠕动,减少胃肠道症状,缩短肛门排气、排便时间,对减轻患者疼痛和改善预后质量效果较为显著;2小茴香热敷结合针灸疗法在降低疼痛方面优于肠内滴注通腑排气汤,更适用于老年或疼痛不耐受患者。
[Abstract]:Objective: to compare the effect of different TCM methods on delayed anal exhaust after gastrointestinal surgery. Methods: a total of 94 patients underwent gastrointestinal surgery in our hospital from April to August, 2014. All the patients were accompanied with anus exhaust delay for 3 days. Three groups were randomly divided into 3 groups, 30 cases in the control group were treated with routine nursing intervention such as postoperative condition monitoring, incision cleaning treatment and other routine nursing interventions, 32 cases in TCM intervention group 1 received warm water foot bath massage on the basis of the control group, 32 cases in the traditional Chinese medicine intervention group were given warm water foot bath massage on the basis of the control group. Soak 25min/ 3 times / d, immerse in foot massage. 32 cases of Chinese medicine intervention group were treated with fennel hot compress combined with acupuncture and moxibustion therapy for 30 mins / twice / d after operation on the basis of control group, all of them were treated continuously for 5 days. The effects of three intervention methods on gastrointestinal motility [motilin, gastrin GASA, serotonin 5-HT] in patients with anus exhaust delay were observed, and the incidence of gastrointestinal symptoms such as abdominal distention, nausea and vomiting, low fever and other related gastrointestinal symptoms were recorded in the two groups. The anus exhaust time, defecation time, visual analogue pain and quality of life (QOL) were compared before and after intervention. Results (1) in terms of gastric dynamics, MTL GAS-5-HT was significantly improved after TCM intervention in both groups, and MTL 5-HT was better than that in control group. There was no significant difference in gastrointestinal symptoms between the two groups. The incidence of adverse gastrointestinal symptoms was significantly decreased in group 1 and 2 compared with that in control group, but there was no significant difference between the two groups in the incidence of adverse gastrointestinal symptoms, but no significant difference between the two groups in the incidence of adverse gastrointestinal symptoms (P0. 05%) and exhaust gas (P 0. 05%) in the control group (P 0. 05), but there was no significant difference between the two groups (P 0. 05, P 0. 05). Defecation: the anal exhaust and defecation time of group 1 and 2 were significantly lower than that of control group (P 0.05), but there was no significant difference between the two groups in the aspect of VASA SF-36: the VAS of group 1 and 2 was lower than that of control group (P 0.05), and the time of defecation was higher than that of control group (P < 0.05). The VAS of TCM group 2 was lower than that of TCM group 1, and the difference was significant (P 0.05). Conclusion the combination of fennel hot compress with acupuncture and moxibustion and warm water foot bath massage can effectively improve gastrointestinal motility, promote gastrointestinal peristalsis, reduce gastrointestinal symptoms and shorten anal exhaust in patients with delayed anal exhaust after gastrointestinal surgery. The effect of defecation time on relieving pain and improving the quality of prognosis was obvious. 2 the combination of fennel hot compress and acupuncture therapy was better than enteral infusion of Tongfu and exhaust decoction in reducing pain, which was more suitable for elderly patients or patients with pain intolerance.
【作者单位】：德阳市第二人民医院;四川大学华西医院;
【分类号】：R248.2

【相似文献】