中药封包和穴位贴敷预防多节段脊柱手术患者腹胀便秘的效果观察  

Effect of Traditional Chinese Medicine hot compress and acupoint application on prevention of abdominal distension and constipation after multiple-level spinal fixation surgery

作　　者：黄丽君 陈子豪 欧肇兰[1] 罗春晓[1] HUANG Lijun;CHEN Zihao;OU Zhaolan;LUO Chunxiao(Department of Spine Surgery,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,510630)

机构地区：[1]中山大学附属第三医院脊柱外科,广东广州510630

出　　处：《中西医结合护理》2023年第12期117-122,共6页Chinese Journal of Integrative Nursing

基　　金：中山大学附属第三医院护理科研基金项目(2020HL09)。

摘　　要：目的比较中药封包与穴位贴敷预防多节段脊柱手术患者术后腹胀、便秘发生的效果。方法本研究为前瞻性随机对照研究。选取2020年8月—2021年11月医院收治的符合纳入标准的患者60例,随机分为中药封包组和穴位贴敷组,每组30例,在常规术后护理的基础上分别实施中药封包和穴位贴敷疗法。收集同期未入组的30例患者作为对照组。主要指标为术后首次排气、排便时间,次要指标为术后第3天腹围、术后第3天腹胀评分及患者满意度。结果首次排气时间中药封包组为(20.80±13.00)h,穴位贴敷组为(21.70±13.70)h,均低于对照组的(38.00±14.60)h(P<0.01;P<0.01)。首次排便时间中药封包组为(69.10±24.90)h,穴位贴敷组为(82.80±26.50)h,均低于对照组的(100.80±28.20)h(P<0.01;P<0.05),且中药封包组优于穴位贴敷组(P<0.05)。术后3 d腹胀评分,中药封包组为(0.23±0.43)分,穴位贴敷组为(0.57±0.73)分,均低于对照组的(1.07±0.87)分(P<0.01;P<0.01),且中药封包组优于穴位贴敷组(P<0.05)。中药封包组满意率100%(30/30),高于穴位贴敷的90.00%(27/30)及对照组的73.33%(22/30)(P<0.01;P<0.01)。结论中药封包及穴位贴敷均能有效预防多节段脊柱手术患者术后腹胀和便秘,且中药封包治疗在缩短患者首次排便时间、缓解腹胀症状等方面均优于穴位贴敷治疗。Objective To compare the effect of Traditional Chinese Medicine(TCM)hot compress and acupoint application on prevention of abdominal distension and constipation after multiple-level spinal fixation surgery.Methods This study was a prospective,randomized con-trolled clinical trial conducted at a single institution.From August 2020 to November 2021,pa-tients who met the inclusion criteria were allocated to TCM hot compress group and acupoint appli-cation group(each for 30 patients).Another 30 more patients without intervention were recruited as control group.Primary outcomes included the time to first flatus and time to first defecation.Secondary outcomes included 3-day postoperative abdominal girth,3-day postoperative abdomi-nal distension and patient’s satisfaction.Results Time to first flatus was(20.80±13.00)h in TCM hot compress group,(21.70±13.70)h in acupoint application group,both of which was lower than(38.00±14.60)h of control group(P<0.01;P<0.01).Time to first defecation was(69.10±24.90)h in TCM hot compress group,lower than(82.80±26.50)h in acupoint applica-tion group(P<0.05),both of which was lower than(100.80±28.20)h in control group(P<0.01;P<0.05).The 3-day postoperative bloating score was(0.23±0.43)in TCM hot compress group,lower than(0.57±0.73)in acupoint application group(P<0.05),both of them lower than(1.07±0.87)in control group(P<0.01;P<0.01).The satisfaction rate was 100%(30/30)in Chinese medicine hot compress group,higher than 90.00%(27/30)in acupoint application group and73.33%(22/30)in control group(P<0.01;P<0.01).Conclusion Both TCM hot compress and acupoint application are effective in preventing abdominal distension and constipa-tion after multiple-level spinal fixation surgery.TCM hot compress therapy shows a better thera-peutic effect in aspects of shorter time to first defecation and relief of abdominal distension.

关 键 词：脊柱外科 内固定手术 腹胀 便秘 中药封包 穴位贴敷 

分 类 号：R248.2[医药卫生—中医临床基础]