發(fā)布時間：2018-11-20 11:37

【摘要】：目的:觀察分析腸內(nèi)外營養(yǎng)結(jié)合針灸在術(shù)后胃癱治療中的療效。方法:收集并分析2005年1月至2016年10月因胃癌在皖南醫(yī)學院第一附屬醫(yī)院行根治性胃大部切除術(shù)后并發(fā)胃癱的患者資料,術(shù)后胃癱患者按有無接受腸內(nèi)外營養(yǎng)和針灸的治療分為腸內(nèi)營養(yǎng)結(jié)合針灸組(n=12)、腸外營養(yǎng)結(jié)合針灸組(n=9)和單純腸內(nèi)營養(yǎng)組(n=9)。比較三組患者術(shù)后住院天數(shù)和術(shù)后淋巴細胞計數(shù)、血紅蛋白、總蛋白、白蛋白的差異。結(jié)果:腸內(nèi)營養(yǎng)結(jié)合針灸組、腸外營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者的術(shù)后住院天數(shù)分別為24.83±8.66d、35.78±11.69d、26.67±9.04d;三組間比較差異有統(tǒng)計學意義(p0.05),兩兩間比較顯示:腸內(nèi)營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者術(shù)后住院天數(shù)均比腸外營養(yǎng)結(jié)合針灸組明顯減少,差異有統(tǒng)計學意義(p0.05);腸內(nèi)結(jié)合針灸組術(shù)后住院天數(shù)比單純腸內(nèi)營養(yǎng)組稍減少,但差異無統(tǒng)計學意義(p0.05)。術(shù)后1周三組患者的淋巴細胞計數(shù)、血紅蛋白、總蛋白及白蛋白水平比較,差異無統(tǒng)計學意義,兩組間比較差異也無統(tǒng)計學意義。術(shù)后2周腸內(nèi)營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者的白蛋白均比腸外營養(yǎng)結(jié)合針灸組明顯增多,差異有統(tǒng)計學意義;此外,單純腸內(nèi)營養(yǎng)組術(shù)后2周的血紅蛋白水平明顯高于腸外營養(yǎng)結(jié)合針灸組。腸內(nèi)營養(yǎng)結(jié)合針灸組患者術(shù)后2周的總蛋白和白蛋白比術(shù)后1周顯著增多,差異有統(tǒng)計學意義;單純腸內(nèi)營養(yǎng)組患者術(shù)后2周的血紅蛋白和白蛋白比術(shù)后1周明顯增多,差異有統(tǒng)計學意義;而腸外營養(yǎng)結(jié)合針灸組患者術(shù)后第1周與術(shù)后2周的各項營養(yǎng)指標比較,差異無統(tǒng)計學意義。結(jié)論:腸內(nèi)營養(yǎng)結(jié)合針灸及單純腸內(nèi)營養(yǎng)可明顯改善術(shù)后胃癱癥狀。腸內(nèi)營養(yǎng)結(jié)合針灸與單純腸內(nèi)營養(yǎng)相比,術(shù)后住院天數(shù)的減少和營養(yǎng)狀況的改善不明顯。
[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 鹵8.66 days (35.78 鹵11.69 days) and 26.67 鹵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.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R656

【參考文獻】

相關(guān)期刊論文 前10條

1 Jung-Hee Jang;Deuk-Joo Lee;Chang-Hwan Bae;Ki-Tae Ha;Sunoh Kwon;Hi-Joon Park;Dae-Hyun Hahm;Hyejung Lee;Seungtae Kim;;Changes in Small Intestinal Motility and Related Hormones by Acupuncture Stimulation at Zusanli(ST 36) in Mice[J];Chinese Journal of Integrative Medicine;2017年03期

2 Hui Li;Tian He;Qian Xu;Zhe Li;Yan Liu;Fang Li;Bo-Feng Yang;Cun-Zhi Liu;;Acupuncture and regulation of gastrointestinal function[J];World Journal of Gastroenterology;2015年27期

3 Andrew Ukleja;Kanwarpreet Tandon;Kinchit Shah;Alicia Alvarez;;Endoscopic botox injections in therapy of refractory gastroparesis[J];World Journal of Gastrointestinal Endoscopy;2015年08期

4 胡舉;;賁門癌根治術(shù)后胃癱綜合征診治體會[J];中國醫(yī)刊;2014年10期

5 馬立安;張晨;沈苑;;針灸聯(lián)合腸內(nèi)營養(yǎng)治療胃術(shù)后胃癱綜合征[J];浙江中醫(yī)雜志;2014年09期

6 杭群;姜從橋;駱杰;;胃癌術(shù)后胃癱綜合征的臨床分析[J];中華解剖與臨床雜志;2014年04期

7 汪洋;楊海明;劉瑩露;徐天舒;;針灸治療術(shù)后胃癱綜合征22例的臨床觀察[J];針灸臨床雜志;2013年11期

8 Ming-Hua Du;Hong-Min Luo;Sen Hu;Yi Lv;Zhi-Long Lin;Li Ma;;Electroacupuncture improves gut barrier dysfunction in prolonged hemorrhagic shock rats through vagus anti-inflammatory mechanism[J];World Journal of Gastroenterology;2013年36期

9 王月;龍錦;;腸內(nèi)及腸外營養(yǎng)在根治性遠端胃大部切除術(shù)后胃癱治療中的作用[J];世界華人消化雜志;2013年15期

10 陳振虎;徐發(fā)彬;;針刺“胃三針”治療手術(shù)后胃癱綜合征20例[J];河南中醫(yī);2012年06期

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