本文選題：耳穴壓丸法 + 胸腰椎骨折術(shù)后��； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：觀察利用椎弓根螺釘固定技術(shù)治療脊柱胸腰段骨折,術(shù)后患者腹脹便秘的發(fā)生及恢復(fù)情況。采用耳穴壓丸法干預(yù),觀察該法治療胸腰椎骨折術(shù)后腹脹便秘的療效,以期擴(kuò)大耳穴壓丸法的治療范圍。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醫(yī)院脊柱科行經(jīng)后路椎弓根螺釘內(nèi)固定術(shù)的患者共80例,利用計(jì)算機(jī)生成的隨機(jī)數(shù)字法將80例患者隨機(jī)分成A、B兩組,每組40人。A組為治療組,在術(shù)后常規(guī)護(hù)理(包括飲食指導(dǎo)、心理疏通、腹部按摩等)的基礎(chǔ)上,加用耳穴壓丸法(穴位選取大腸、直腸、小腸、三焦、內(nèi)分泌、胃、脾、腎)進(jìn)行干預(yù)2周。B組為對(duì)照組,單純采用常規(guī)護(hù)理。分別記錄兩組患者術(shù)后肛門首次排氣(h)、排便時(shí)間(d)術(shù)前及術(shù)后6個(gè)時(shí)間點(diǎn)(第2天、3天、5天、7天、2周、1月)腹脹便秘積分情況。利用SPSS20.0對(duì)采集收據(jù)進(jìn)行整理、分析,得出結(jié)論。結(jié)果：A組(治療組)患者術(shù)后首次排氣時(shí)間平均27.4±4.8h,首次排便時(shí)間平均2.7±0.7天；B組(對(duì)照組)患者首次排氣時(shí)間平均37.8±4.6h,首次排便時(shí)間平均3.7±0.8天。治療組首次排氣、排便時(shí)間均明顯早于對(duì)照組,具有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組在耳穴干預(yù)期間(術(shù)后2周內(nèi))各時(shí)間點(diǎn)腹脹便秘積分明顯低于對(duì)照組,峰值小于對(duì)照組,且能夠較快恢復(fù)至術(shù)前水平,各項(xiàng)指標(biāo)表明術(shù)后胃腸功能恢復(fù)均明顯優(yōu)于對(duì)照組。A組共有痊愈11例(28.9%),顯效16例(42.1%),有效8例(21.1%),無效3例(9%),總有效率92.1%。B組患者共有痊愈5例(13.2%),顯效7例(18.4%),有效12例(31.6%),無效14例(36.8%),總有效率63.2%。A組總有效率明顯高于B組,經(jīng)秩和檢驗(yàn),具有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后1月隨訪發(fā)現(xiàn)兩組患者腹脹便秘積分無明顯差異(P0.05)。兩組患者首次排氣時(shí)間、排便時(shí)間隨年齡增長逐漸延長,經(jīng)單因素方差分析具有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后各觀察時(shí)間點(diǎn)腹脹便秘積分隨年齡增長而增加,經(jīng)多因素方差分析,具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1、耳穴壓丸法能夠有效降低胸腰椎骨折患者術(shù)后腹脹便秘的發(fā)生程度,促使胃腸功能盡快恢復(fù)至正常水平。2、患者在基本護(hù)理?xiàng)l件下胃腸功能可以自行恢復(fù)至正常水平,但恢復(fù)周期較長。3、年齡是影響胸腰椎骨折患者術(shù)后腹脹便秘發(fā)生和恢復(fù)的一個(gè)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 鹵4.8 hours, the first defecation time was 2.7 鹵0.7 days in group B (control group) was 37.8 鹵4.6 hours, and the first defecation time was 3.7 鹵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.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.2

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