早期穴位埋线对颅脑损伤患者胃肠功能的维护作用研究  

Maintenance effects of acupoint catgut embedding at early time on gastrointestinal function in patients with craniocerebral injury

作　　者：吴小飞[1] 余娅娟[1] 胡培亚 王思思[1] 

机构地区：[1]浙江省中医院下沙院区ICU,杭州310018

出　　处：《中国针灸》2015年第5期439-442,共4页Chinese Acupuncture & Moxibustion

摘　　要：目的：探讨早期穴位埋线对颅脑损伤患者胃肠功能维护作用的效果。方法：将60例格拉斯哥昏迷量表评分（Glasgow coma scale,GCS）在5~12分的颅脑损伤患者按就诊顺序交替分为观察组和对照组,每组30例。对照组给予常规治疗和护理,观察组在对照组常规治疗和护理的基础上根据患者在入院后24h内所表现的不同病机和症状,辨证取穴进行埋线治疗,观察记录两组患者肠鸣音恢复时间、首次肛门排气时间、首次排便时间,入组后不同时点腹腔压力检测情况,并发症（上消化道出血、腹泻、呕吐）发生率,肠内营养可耐受率达到目标值（30kcal/kg·d）的时间。结果：观察组患者的肠鸣音恢复时间、首次肛门排气时间、首次排便时间、肠内营养可耐受率达到目标值的时间,均早于对照组（均P〈0.01）。观察组入院后48h、4天和7天腹腔压力均低于对照组[（11.10±1.47）mmHg vs（13.50±1.43）mmHg、（8.40±1.25）mmHg vs（11.90±1.56）mmHg、（6.73±0.74）mmHg vs（10.80±1.30）mmHg,均P〈0.01]。观察组消化道出血、腹泻、呕吐3种并发症的发生例数为8例,发生率为26.7%（8/30）,低于对照组的70.0%（21/30,P〈0.01）。结论：对颅脑损伤患者进行早期穴位埋线可促进患者胃肠功能恢复,减少肠内营养的不耐受和各种并发症的发生。Objective To explore the maintenance effects of acupoint catgut embedding at early time on gastrointestinal function in patients with craniocerebral injury.Methods Sixty craniocerebral injury patients with 5to12 points of Glasgow coma scale（GCS）,according to treatment order,were alternately divided into an observation group and a control group,30 cases in each one.Patients in the control group were treated with regular treatment and nursing care.Based on this,patients in the observation group,according to different pathogenesis and symptoms presented within 24 hinto hospitalization,were additionally treated with acupoint catgut embedding.The recovery time of borborygmus,time of first anal aerofluxus,time of first defecation,abdominal pressure at different time points,the occurrence rate of complications（upper gastrointestinal hemorrhage,diarrhea,vomiting）,time of enteral nutrition tolerance rate reaching 30kcal/kg·d were observed and recorded.Results The recovery time of borborygmus,time of first anal aerofluxus,time of first defecation and time of enteral nutrition tolerance rate reaching 30kcal/kg·d in the observation group were all earlier to those in the control group（all P〈0.01）.At 48 h,4dand 7dinto hospitalization,the abdominal pressures in the observation group were all lower than those in the control group [（11.10±1.47）mmHg vs（13.50±1.43）mmHg,（8.40±1.25）mmHg vs（11.90±1.56）mmHg,（6.73±0.74）mmHg vs（10.80±1.30）mmHg,all P〈0.01].There were 8cases with complications of gastrointestinal hemorrhage,diarrhea and vomiting in the observation group with the occurrence rate of26.7%（8/30）,which was lower than those in the control group（70.0%（21/30）,P〈0.01）.Conclusion The acupoint catgut embedding at early time in craniocerebral injury patients could improve the recovery of gastrointestinal function,reduce intolerance of enteral nutrition and occurrence rate of various complications.

关 键 词：颅脑损伤 胃肠功能 穴位埋线 

分 类 号：R246.1[医药卫生—针灸推拿学]