医用几丁糖联合新斯的明足三里注射促进腹部手术患者胃肠功能恢复与预防肠粘连的效果评价  

The Effect of Medical Chitosan Combined with Neostigmine Injected at Zusanli on Gastrointestinal Function Recovery and Prevention of Intestinal Adhesion in Patients Undergoing Abdominal Surgery

作　　者：常喜宅 郭建光[2] 张国辉[2] 齐李强 张海永 CHANG Xi-zhai;GUO Jian-guang;ZHANG Guo-hui;QI Li-qiang;ZHANG Hai-yong(Department of General Surgery,Xingtang County Hospital of Traditional Chinese Medicine,Xingtang,Hebei 050600,China;Department of General Surgery,People's Hospital of Xingtang County,Xingtang,Hebei 050600,China)

机构地区：[1]行唐县中医医院普通外科,河北行唐050600 [2]行唐县人民医院普通外科,河北行唐050600

出　　处：《临床误诊误治》2018年第8期50-54,共5页Clinical Misdiagnosis & Mistherapy

基　　金：石家庄市科学技术研究与发展指导计划项目(171461803)

摘　　要：目的探讨医用几丁糖联合新斯的明足三里注射促进腹部手术患者胃肠功能恢复与预防肠粘连的效果。方法选择2015年8月—2017年7月行唐县中医医院收治的腹部手术186例,采用随机数字表法随机将其分为观察组和对照组两组各93例。两组均视疾病类型给予相应手术治疗。对照组关腹前腹腔脏器表面及壁腹膜涂抹医用几丁糖,观察组在此基础上术后给予新斯的明足三里注射。观察比较两组术后肠鸣音恢复时间、排气恢复时间、排便恢复时间,手术前后炎性因子变化情况,术后肠粘连和不良反应发生情况。结果观察组术后肠鸣音恢复时间、排气恢复时间、排便恢复时间及术后6个月肠粘连发生率均短于或低于对照组,差异有统计学意义(P<0.05)。术后观察组和对照组血白细胞介素6(IL-6)、白细胞介素10(IL-10)和肿瘤坏死因子α(TNF-α)水平均较术前显著升高,差异有统计学意义(P<0.05);观察组血IL-6、IL-10和TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。结论在腹腔脏器表面及壁腹膜涂抹医用几丁糖基础上予新斯的明足三里注射可促进腹部手术患者胃肠功能恢复,并能降低炎性因子水平,预防肠粘连。Objective To investigate the effect of medical chitosan combined with neostigmine on gastrointestinal function recovery and prevention of intestinal adhesion in patients undergoing abdominal surgery.Methods A total of 186 patients who underwent abdominal surgery in Xingtang County Hospital of Traditional Chinese Medicine and People's Hospital of Xingtang County from August 2015 to October 2017 were selected as the subjects.The patients were randomly divided into the observation group and the control group,with 93 patients in each group by random digital table.The two groups received routine surgical treatment depending on the type of disease.The control group was coated with medical chitosan on the surface of the abdominal organs and the parietal peritoneum before the abdomen was closed,whereas the observation group was injected with neostigmine at Zusanli after surgery on the basis of the control group.The postoperative recovery time of bowel sounds,postoperative exhaust and defecation,the occurrence of postoperative intestinal adhesion and adverse reactions,and the changes of inflammatory cytokines before and after surgery were compared in the two groups.Results The recovery time of bowel sounds,postoperative exhaust and defecation as well as the incidence of intestinal adhesion 6 months after operation was shorter or lower than those in the control group,and significant differences were found(P<0.05).After operation,the levels of IL-6,IL-10 and TNF-αin the observation group and the control group were significantly higher than those before operation,and the difference was statistically significant(P<0.05).The levels of IL-6,IL-10 and TNF-αin the observation group after operation were lower than those in the control group,suggesting significant differences(P<0.05).Conclusion The application of medical Chitosan on the surface of abdominal organs and the parietal peritoneum coupled with injection of neostigmine at Zusanli can promote the recovery of gastrointestinal function in patients undergoing abdominal surg

关 键 词：外科手术 腹部 几丁糖 新斯的明 

分 类 号：R656[医药卫生—外科学]