淡渗利湿法治疗慢传输型便秘术后严重腹泻的疗效观察

发布时间：2018-10-05 15:06

【摘要】：目的：淡渗利湿法治疗慢传输型便秘术后严重腹泻的疗效观察方法：采用前瞻性随机对照分析方法、对我科2013年5月至2014年12月收治的65例重度慢传输型便秘患者行结肠次全切术后治疗进行随机对照治疗。分别采用传统治疗方式和加用淡渗利湿药治疗方式。两组患者在年龄、性别、手术方式无明显差别,具有对比性。其中传统方式治疗组(对照组)30例,采用留置胃肠减压装置、禁食禁饮、合理使用抗菌素、对症、支持治疗纠正水、电解质和酸碱平衡紊乱、肠外营养支持,术后严重腹泻症状加用蒙脱石散、复方苯乙哌啶;加用淡渗利湿药组(治疗组)35例,在采用传统治疗方式上加用口服淡渗利湿药。观察两组的临床指标,即腹泻症状改善程度,包括腹痛腹泻症状、每日排便次数、有无直肠刺激征、大便性状等疗效指标,进一步比较两组的各项指标是否具有统计学差异。结果：两组患者均采取术后随访观察疗效并收据相应数据,随访时间为半年至一年,对慢传输型便秘患者结肠次全切术后腹泻症状改善程度进行对比。回访内容包括腹痛腹泻症状、每日排便次数、有无直肠刺激征、大便性状等疗效指标等多个方面。治疗组患者的术后腹泻症状改善率优于对照组。治疗组的平均每天大便次数(3.35±1.86)明显少于对照组(7.25±3.62ml/L)。治疗效果上治疗组有效率为91.42%；对照组有效率为80.00%。治疗组的有效率明显高于对照组,两组差异具有统计学意义(P0.05)。结论：结肠次全切除术治疗重度慢传输型便秘是目前外科公认疗效较好的治疗方案,但术后多数患者存在较难控制的腹泻症状。手术治疗后加用淡渗利湿药口服,对有效的缓解患者的腹痛腹泻、排便次数增多、直肠刺激征、大便稀溏等症状有一定帮助。
[Abstract]:Objective: to observe the curative effect of light infiltration and dampness therapy on severe diarrhea after slow transit constipation. From May 2013 to December 2014, 65 patients with severe slow transit constipation were treated with subtotal colectomy. They were treated by the traditional treatment and the treatment with light osmosis and dampness medicine respectively. There was no significant difference in age, sex and operation between the two groups. In the traditional treatment group (control group), 30 cases were treated with indwelling gastrointestinal decompression device, fasting and drinking, rational use of antibiotics, symptomatic treatment, support treatment and correction of water, electrolyte and acid-base balance disorder, parenteral nutrition support. The symptoms of severe diarrhea were treated with montmorillonite powder, compound phenethylpiperidine, and the treatment group (35 cases) with mild infiltration and dampness. The clinical indexes, including abdominal pain, diarrhea symptoms, defecation times, rectal irritation and defecation traits, were observed in the two groups. Results: the patients in both groups were followed up for six months to one year. The improvement of diarrhea symptoms after subtotal colonic resection in patients with slow transit constipation was compared. The contents include abdominal pain and diarrhea symptoms, defecation times, rectal irritation symptoms, defecation traits and other therapeutic indicators. The improvement rate of diarrhea symptoms in the treatment group was better than that in the control group. The average number of defecation in the treatment group (3.35 卤1.86) was significantly lower than that in the control group (7.25 卤3.62ml/L). The effective rate was 91.42 in the treatment group and 80.00in the control group. The effective rate in the treatment group was significantly higher than that in the control group, and the difference between the two groups was statistically significant (P0.05). Conclusion: subtotal colectomy for severe slow transit constipation is a good surgical treatment, but most of the patients have diarrhea symptoms which are difficult to control after operation. It is helpful to relieve abdominal pain and diarrhea, increase defecation times, rectal irritation sign, loose stool and so on.
【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】：R269

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