【摘要】：目的:術(shù)后胃腸功能障礙是術(shù)后患者出現(xiàn)惡心嘔吐、腹脹腹痛、大便困難等不適癥狀,是腹部手術(shù)后常見(jiàn)的并發(fā)癥。其既影響患者的術(shù)后恢復(fù),也延長(zhǎng)了住院時(shí)間,增加了患者院內(nèi)感染和深靜脈血栓等風(fēng)險(xiǎn),同時(shí)也造成了患者及社會(huì)的經(jīng)濟(jì)負(fù)擔(dān)。本研究旨在觀察穴位埋線治療腹部手術(shù)后胃腸功能障礙的臨床療效,用更安全、更有效的方法緩解患者不適癥狀,為臨床治療術(shù)后胃腸功能障礙提供新的診療思路和嚴(yán)謹(jǐn)?shù)目蒲匈Y料,使針灸治療該病的方法及用穴更加科學(xué)和規(guī)范。方法:本課題遵循循證醫(yī)學(xué)、臨床流行病學(xué)/DME的原則,把2016年2月至2017年2月在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院二外科病房收治的開(kāi)腹手術(shù)后,符合納入條件的患者(共64名)隨機(jī)分為埋線組(共31名)和普通針刺組(共33名);穴位埋線組在術(shù)后給予雙側(cè)足三里、雙側(cè)上巨虛、雙側(cè)大腸俞穴位埋線,分別比較兩組術(shù)后腸鳴音恢復(fù)時(shí)間、首次排氣、首次排便、恢復(fù)全流飲食時(shí)間、術(shù)后住院天數(shù)。數(shù)據(jù)處理采用t檢驗(yàn)、方差分析及秩和檢驗(yàn)方法對(duì)療效結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)驗(yàn)、方差分析及秩和檢驗(yàn)方法對(duì)療效結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析,用組間比較用方差分析兩組間療效差異。以客觀評(píng)價(jià)穴位埋線的療效和安全性。結(jié)果:術(shù)后予穴位埋線的患者在腸鳴音恢復(fù)時(shí)間、首次排氣時(shí)間等觀察指標(biāo)與普通針刺組的比較差異不具有統(tǒng)計(jì)學(xué)意義。但在術(shù)后首次排便時(shí)間、恢復(fù)全流飲食時(shí)間、住院天數(shù)等觀察指標(biāo)中時(shí)間短于普通針刺組,且具有統(tǒng)計(jì)學(xué)意義(P0.05)。在療效比較上埋線組總有效率96.77%,普通針刺組總有效率90.9%,具有統(tǒng)計(jì)學(xué)意義。結(jié)論:術(shù)后予穴位埋線可促進(jìn)術(shù)后胃腸功能障礙的恢復(fù),且其治療療效優(yōu)于普通針刺組。
[Abstract]:Objective: postoperative gastrointestinal dysfunction is a common complication after abdominal surgery, such as nausea and vomiting, abdominal distention and abdominal pain, defecation difficulty. It not only affects the postoperative recovery, but also prolongs the hospital stay, increases the risk of nosocomial infection and deep venous thrombosis, and causes the economic burden of patients and society. The purpose of this study was to observe the clinical efficacy of catgut embedding at acupoints in the treatment of gastrointestinal dysfunction after abdominal surgery, and to use a safer and more effective method to relieve the discomfort symptoms of the patients. For clinical treatment of postoperative gastrointestinal dysfunction to provide new ideas and rigorous scientific research data, acupuncture treatment of the disease and the use of points more scientific and standardized. Methods: following the principle of Evidence-based Medicine, Clinical Epidemiology / DME, we treated the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine with open surgery from February 2016 to February 2017. 64 patients (64 patients) were randomly divided into two groups: group B (n = 31) and group A (n = 33). The recovery time of bowel sound, the first exhaust, the first defecation, the recovery time of whole stream diet, and the days of postoperative hospitalization were compared between the two groups. T test, ANOVA and rank sum test were used to analyze the results of data processing. Objective to evaluate the efficacy and safety of catgut implantation at acupoints. Results: there was no significant difference in the recovery time and the first exhaust time between the patients with acupoint embedding thread and the normal acupuncture group. However, the time of first defecation, the time of recovery of whole flow diet and the days of hospitalization were shorter than that of the normal acupuncture group, and had statistical significance (P0.05). The total effective rate was 96.77 in the embedding group and 90.9 in the common acupuncture group, which was statistically significant. Conclusion: postoperative catgut implantation can promote the recovery of gastrointestinal dysfunction after operation, and the therapeutic effect is better than that of the common acupuncture group.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R246.2
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本文編號(hào)：2220742