几丁糖联合针灸预防腹部术后粘连性肠梗阻的研究  

Prevention of adhesive intestinal obstruction after abdominal surgery with chitosan combined with Acupuncture

作　　者：黎鉴秋 梁家源 何柏辉 陈金胜 张超 LI Jianqiu;LIANG Jiayuan;HE Bohui;CHEN Jinsheng;ZHANG Chao(Yu'nan People's Hospital,Yu'nan 510180,China;Yu'nan Hospital of Traditional Chinese Medicine,Yu'nan 527199,China)

机构地区：[1]广东省郁南县人民医院,广东郁南510180 [2]广东省郁南县中医院,广东郁南527199

出　　处：《中国医药科学》2018年第7期63-66,共4页China Medicine And Pharmacy

基　　金：广东省云浮市医学科学技术研究基金(2013B94)

摘　　要：目的探讨几丁糖联合针灸治疗对预防腹部术后粘连性肠梗阻临床影响的研究。方法选取2013年1月~2015年6月于我院接受治疗的68例腹部手术患者为研究对象,按照随机数字表法分为两组,其中采用常规治疗方案治疗的34例患者为对照组,其余在几丁糖基础上添加针灸联合治疗的34例患者为观察组。采用菲利普斯国际肠粘连分级指标对患者肠粘连程度进行分类,同时计算粘连性肠梗阻发生率。统计两组患者治疗过程中出现的腹痛、肠坏死、便秘肠梗阻等不良反应,采用国际改良疗效评价量表对患者疗效进行综合评价,计算总有效率。结果研究发现,随访结果显示,观察组患者肛门排气排便时间为(36.39±11.30)h,住院时间为(13.28±3.29)d;对照组患者(46.19±13.20)h,住院时间为(19.78±4.12)d,观察组患者发现Ⅲ级1例占2.94%、Ⅳ级0例占0,粘连例数少于对照组患者,同时观察组患者Ⅰ级22例64.71%及Ⅱ级11例32.35%,粘连例数多于对照组患者,观察组粘连性肠梗阻发生率2.94%,低于对照组患者14.71%,观察组再次手术率为2例5.88%,少于对照组患者4例11.76%,但两组患者差异不明显。两组患者均出现不同程度并发症发生情况,其中观察组患者并发症发生率为17.65%,少于对照组患者35.29%。疗效评价方面,观察组患者无效例数1例占2.94%,少于对照组患者无效例数6例占17.65%,同时显效例数为21例61.76%,有效例数为12例35.29%,均多于对照组患者,观察组患者总有效率为97.06%,高于对照组患者总有效率82.35%。结论几丁糖联合针灸治疗方式能够有效预防腹部术后患者粘连性肠梗阻的发生,预防效果较单一针灸治疗更好,同时患者并发症发生情况较少,死亡率大幅下降。Objective To explorethe clinical effect of chitosan combined with acupuncture on prevention of adhesive intestinal obstruction after abdominal surgery.Methods 68 cases with abdominal surgery were selected from February 2014 to April 2017 in our hospital as the research object,and the patients were divided into 2 groups according to randomly table.The treatment of 34 cases of conventional therapy patients were the control group,and the addition of chitosan in acupuncture combined treatment of 34 patients were the observation group.Phillips’s international intestinal adhesion index was used to classify the degree of intestinal adhesion,and the incidence of adhesive intestinal obstruction was calculated.The adverse reactions such as abdominal pain,intestinal necrosis,constipation,intestinal obstruction and other adverse reactions occurred in the two groups were evaluated.The curative effect was evaluated by the international modified efficacy scale,and the total effective rate was calculated.Results The study found that the follow-up results showed that patients in the observation group anal exhaust defecation time was(36.39±11.30)hours,hospitalization time was(13.28±3.29)days;patients in the control group(46.19±13.20)hours,hospitalization time was(19.78±4.12)days,patients in the observation group found 1 cases of grade III and grade IV in 0 case accounted for 2.94%,0.00%,the number of cases bigger than the control group,while the patients in the observation group grade I were 22 cases of64.71%and grade II were11 cases of 32.35%,adhesion cases were bigger than the number of patients in the control group,the observation group of adhesive intestinal obstruction occurred was 2.94%,14.71%which were lower than the control group,the observation group of 2 cases of reoperation rate was 5.88%,higher than the control group of 4 patients with 11.76%,but the differences between the two groups were not significant.Two groups of patients had different levels of complications,in which the number of complications in the obse

关 键 词：几丁糖 联合针灸 腹部术后 粘连性肠梗阻 研究 

分 类 号：R656[医药卫生—外科学]