艾灸联合阶梯性镇痛护理对改善LC+LCBDE患者术后不适的效果研究  

Moxibustion plus analgesic ladder nursing mode in improving postoperative pain in patients undergone LC and LCBDE

作　　者：张志云 王亚 徐姝娟 徐翠 谢嗣红 刘金枝 ZHANG Zhiyun;WANG Ya;XU Shujuan;XU Cui;XIE Sihong;LIU Jinzhi(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院肝胆外科,安徽芜湖241001 [2]皖南医学院第一附属医院弋矶山医院护理部,安徽芜湖241001

出　　处：《皖南医学院学报》2022年第4期406-408,共3页Journal of Wannan Medical College

基　　金：安徽省重点研究与开发计划项目(1804h08020273)。

摘　　要：目的:探讨中医艾灸联合阶梯性镇痛护理模式在腹腔镜胆囊切除术(LC)+腹腔镜胆总管探查术(LCBDE)患者中的应用效果。方法:选择2020年11月~2021年11月在弋矶山医院治疗的100例胆囊结石合并胆总管结石患者,其中对照组50例采用常规护理方式,观察组50例在此基础上使用中医艾灸联合阶梯性镇痛护理模式。对比两组患者术后不同节点的疼痛程度及胃肠功能恢复情况。结果:观察组术后第1、3天视觉模拟评分法(VAS)评分[(1.74±0.49)分和(1.66±0.55)分]均低于对照组[(2.14±0.61)分和(1.96±0.45)分],P<0.05;对照组术后第1次通气、第1次排便及肠鸣音恢复时间[(41.46±24.00)h、(77.76±33.83)h和(16.32±10.91)h]均短于对照组[(78.40±31.87)h、(93.72±34.83)h和(21.42±6.62)h],P<0.05;观察组并发症发生率[6.0%(3/50)]低于对照组[22.0%(11/50)]),P<0.05。结论:艾灸联合阶梯性镇痛护理可有效减轻LC+LCBDE患者术后腹部疼痛,促进患者术后胃肠功能恢复,同时降低患者术后并发症的发生率。Objective:To evaluate the efficacy of moxibustion, a traditional Chinese medicine therapy combined with analgesic ladder nursing mode in improving the postoperative pain in patients undergone laparoscopic cholecystectomy(LC) and laparoscopic common bile duct exploration(LCBDE).Methods:One hundred patients of cholecystolithiasis concomitant with choledocholithiasis treated in our hospital were included between November 2020 and November 2021,and divided into control group(n=50,nursed with conventional procedure) and observational group(n=50,pain relief managed by traditional Chinese moxibustion plus analgesic ladder nursing mode on routine nursing basis).The two groups were compared concerning the pain degree and recovery of gastrointestinal function at different time point.Results:Patients in the observational group had lover VAS scores at day 1 and 3 after operation, earlier recovery of first exhaustion, bowel movement and bowel sounds and lower complications than those in the control group[1.74±0.49 vs. 1.66±0.55,2.14±0.61 vs. 1.96±0.45,(41.46±24.00) h vs.(77.76±33.83) h and(16.32±10.91) h vs.(78.40±31.87) h,(93.72±34.83) h and(21.42 ±6.62) h, 6.0%(3/50) vs. 22.0(11/50),respectively, all P<0.05)].Conclusion:Combined traditional Chinese medicine therapy of moxibustion analgesic ladder care mode can effectively reduce postoperative abdominal pain, facilitate early recovery of gastrointestinal function after surgery, and reduce the incidence of postoperative complications in patients undergone LC and LCBDE.

关 键 词：胆囊结石 胆总管结石 艾灸 疼痛护理 功能恢复 

分 类 号：R473.6[医药卫生—护理学] R473.3[医药卫生—临床医学]