耳穴压豆对腹腔镜胆总管切开取石+T管引流术患者术后胆汁成分的影响  

The effect of ear-acupoint pressing on bile composition after laparoscopic choledocholithotomy+T-tube drainage

作　　者：郭锋满 李建明[1] 陈壮浩[1] 宋巍巍[1] 陈顺 GUO Feng-man;LI Jian-ming;CHEN Zhuang-hao(Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)

机构地区：[1]中山市中医院,528400

出　　处：《中国现代药物应用》2024年第16期132-136,共5页Chinese Journal of Modern Drug Application

基　　金：中山市医学科研项目(项目编号:2022A020556)。

摘　　要：目的分析耳穴压豆对腹腔镜胆总管切开取石+T管引流术患者术后胆汁成分的影响。方法66例胆管结石患者,随机分为对照组和观察组,每组33例。两组均予以腹腔镜胆总管切开取石+T管引流术治疗,对照组术后给予常规对症治疗,观察组在对照组基础上术后给予耳穴压豆治疗。比较两组患者术后不同时间点的胆汁成分、肝功能及术后胆汁总引流量。结果观察组术后第4天胆汁中总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆汁酸(TBA)、钙离子(Ca^(2+))、胆固醇(CHO)分别为(520.46±110.15)μmol/L、(350.36±80.07)μmol/L、(270.45±40.06)μmol/L、(1042.34±130.05)μmol/L、(1.56±0.15)mmol/L、(4.01±0.92)mmol/L,术后第8天分别为(359.47±71.35)μmol/L、(242.24±50.34)μmol/L、(222.16±40.31)μmol/L、(1232.10±150.43)μmol/L、(1.38±0.15)mmol/L、(3.59±0.47)mmol/L;对照组术后第4天胆汁中TBIL、DBIL、IBIL、TBA、Ca^(2+)、CHO分别为(572.93±97.27)μmol/L、(390.52±69.17)μmol/L、(294.78±56.22)μmol/L、(929.48±135.27)μmol/L、(1.76±0.19)mmol/L、(4.47±0.89)mmol/L,术后第8天分别为(495.53±83.86)μmol/L、(344.41±62.06)μmol/L、(264.47±43.36)μmol/L、(1003.87±152.18)μmol/L、(1.57±0.17)mmol/L、(3.99±0.43)mmol/L。术后第4、8天,两组患者胆汁中TBIL、DBIL、IBIL、Ca^(2+)、CHO较术后第1天显著降低,且观察组低于对照组;两组患者胆汁中TBA较术后第1天显著升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。术后第4、8天,两组患者谷丙转氨酶(ALT)、谷草转氨酶(AST)较术后第1天降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组术后胆汁总引流量为(2684.65±252.45)ml,多于对照组的(2135.89±295.42)ml,差异有统计学意义(P<0.05)。结论对腹腔镜胆总管切开取石+T管引流术患者术后予以耳穴压豆治疗,可改变胆汁成分及肝功能,能增加TBA及胆汁排空能力,降低胆红素和Ca^(2+)含量,效果理Objective To analyze the effect of ear-acupoint pressing on bile composition after laparoscopic choledocholithotomy+T-tube drainage.Methods 66 patients with bile duct stones were randomly divided into a control group and an observation group,with 33 cases in each group.Both groups were treated with laparoscopic choledocholithotomy+T-tube drainage.The control group was treated with conventional symptomatic treatment after surgery,and the observation group was treated with ear-acupoint pressing on the basis of the control group.The bile composition and liver function at different postoperative time periods,and the total volume of the bile drained of the two groups of patients were compared.Results In the observation group,on the 4st day after surgery,the total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),total bile acid(TBA),calcium ion(Ca^(2+))and cholesterol(CHO)in the bile were(520.46±110.15)μmol/L,(350.36±80.07)μmol/L,(270.45±40.06)μmol/L,(1042.34±130.05)μmol/L,(1.56±0.15)mmol/L and(4.01±0.92)mmol/L;on the 8th day after surgery,they were(359.47±71.35)μmol/L,(242.24±50.34)μmol/L,(222.16±40.31)μmol/L,(1232.10±150.43)μmol/L,(1.38±0.15)mmol/L and(3.59±0.47)mmol/L.In the control group,on the 4st day after surgery,TBIL,DBIL,IBIL,TBA,Ca^(2+)and CHO in the bile were(572.93±97.27)μmol/L,(390.52±69.17)μmol/L,(294.78±56.22)μmol/L,(929.48±135.27)μmol/L,(1.76±0.19)mmol/L and(4.47±0.89)mmol/L;on the 8th day after surgery,they were(495.53±83.86)μmol/L,(344.41±62.06)μmol/L,(264.47±43.36)μmol/L,(1003.87±152.18)μmol/L,(1.57±0.17)mmol/L and(3.99±0.43)mmol/L.On the 4th and 8th day after surgery,TBIL,DBIL,IBIL,TBA,Ca^(2+)and CHO in the bile of the two groups were significantly decreased compared with those on the 1st day after surgery,and the observation group was lower than the control group(P<0.05).On the 4th and 8th day after surgery,TBA in the bile of the two groups was significantly higher than that on the 1st day after surgery,and the observation group was higher than

关 键 词：耳穴压豆 胆总管切开取石术 T管引流术 胆汁成分 

分 类 号：R657.4[医药卫生—外科学]