穴位敷贴及中药足浴联合ERAS技术对腹腔镜子宫全切术后胃肠功能恢复的影响  

Effect of Postoperative Recovery of Gastrointestinal Function of Patients Undergoing Laparoscopic Hysterectomy in ERAS Procedure Combined with Acupoint Application and Traditional Chinese Herbs Foot Bath

作　　者：韩旭东[1] 吴珍珍[2] 李芳[2] 王文第[3] 王剑[3] 李怡林[2] HAN Xudong;WU Zhenzhen;LI Fang;WANG Wendi;WANG Jian;LI Yilin(Department of Anesthesiology,Gansu Provincial Maternity and Child Care Hospital,Lanzhou 730050,China;Department of Gynaecology,Gansu Provincial Maternity and Child Care Hospital,Lanzhou 730050,China;Science Center,Gansu Provincial Maternity and Child Care Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院麻醉手术科,兰州730050 [2]甘肃省妇幼保健院妇科,兰州730050 [3]甘肃省妇幼保健院科研中心,兰州730050

出　　处：《宁夏医科大学学报》2021年第1期48-51,共4页Journal of Ningxia Medical University

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2014-18);兰州市人才创新创业项目(2016-RC-48)。

摘　　要：目的探讨穴位敷贴及中药足浴联合ERAS技术对腹腔镜子宫全切术患者术后胃肠功能恢复的影响。方法选取2018年10月至2019年10月在甘肃省妇幼保健院行腹腔镜子宫全切术患者90例,采用随机数字表法将患者分为中医疗法联合加速康复外科组(TE组)和加速康复外科组(E组),每组45例。TE组围术期实施加速康复外科技术方案并应用穴位敷贴及中药足浴疗法,E组实施加速康复外科技术方案。观察两组患者术后首次肛门排气时间、术后恶心呕吐发生率以及术前1 d(T0)、术后24 h(T1)、48 h(T2)血清胃泌素(GAS)、胃动素(MTL)及血管活性多肽(VIP)浓度,比较两组患者术后住院天数、住院费用差异。结果 TE组肛门排气时间早于E组(P<0.05),恶心呕吐发生率低于E组(P<0.05)。两组患者平均术后住院天数及住院费用比较差异均无统计学意义(P均>0.05)。TE组T2时GAS、MTL浓度均高于E组(P均<0.05);两组间各时间点VIP浓度差异均无统计学意义(P均>0.05);E组T2时GAS浓度比T0时低(P<0.05),TE组T2时MTL浓度均高于T0及T1时浓度(P均<0.05)。结论穴位敷贴及中药足浴疗法联合加速康复外科技术能够促进腹腔镜子宫全切术患者术后胃肠功能恢复。Objective To evaluate the effect of postoperative recovery of gastrointestinal function of patients undergoing laparoscopic hysterectomy in ERAS procedure combined with acupoint application and traditional Chinese herbs foot bath. Methods Ninety patients scheduled laparoscopic hysterectomy in Gansu Maternity and Child Care Hospital from October 2018 to October 2019 were divided into two groups(n=45)using a random number table method:group TE and group E. Group TE were treated with ERAS procedure and TCM therapy,including acupoint application and traditional Chinese herbs foot bath in preoperative. Group E were treated with ERAS procedure. The time of first anal exhaust after operation,incidence of postoperative nausea and vomiting,serum gastrin(gas),motilin(MTL)and vasoactive polypeptide(VIP)concentrations on the day before operation(T0),24 h(T1)and 48 h(T2)after operation were observed,and the differences of hospitalization days and hospitalization expenses between the two groups were observed. Results The time of anal exhaust in group TE was earlier than that in group E(P<0.05). The incidences of nausea and vomiting in group TE were lower than those in group E(P<0.05). There was no significant difference between two groups in postoperative hospital stay and hospitalization cost(P all>0.05). Compared with group E,the concentration of GAS and MTL in group TE were increased at T2(P all<0.05). There were no significant difference between two groups in the concentration of VIP at all observation points(P all>0.05). Compared with T0,the concentration of GAS in group E was decreased at T2(P<0.05). Compared with T0 and T1,the concentration of MTL in group TE was increased at T2(P all<0.05). Conclusion ERAS procedure combined with acupoint application and traditional Chinese herbs foot bath can effectively promote the postoperative recovery of gastrointestinal function of patients.

关 键 词：中医疗法 加速康复外科 子宫全切术 胃肠功能 

分 类 号：R713.42[医药卫生—妇产科学]