穴位注射新斯的明对肝癌TACE术后腹胀治疗价值探讨

Acupoint injection of neostigmine on abdominal distension of hepatocellular carcinoma after TACE

目的观察穴位注射新斯的明对肝癌TACE术后腹胀的临床治疗价值。方法 2010年6月至2012年6月,我院诊治的96例肝癌TACE术后腹胀患者,根据随机数字法,将其分为对照组(常规治疗和护理)和观察组(对照组基础上,给予穴位注射新斯的明),每组各48例。比较两组临床疗效、肛门排气时间、肠鸣音次数以及不良反应。结果观察组48例患者中,21例显效、20例有效、7例无效;对照组48例患者中,11例显效、21例有效、16例无效。观察组的治疗总有效率明显高于对照组(85.4%vs 66.7%),两组比较差异有统计学意义(P<0.05);与对照组相比,观察组肛门排气时间明显缩短(11.5±9.9 vs 37.6±10.4),肠鸣音次数明显增多(5.9±1.8 vs 0.9±0.5),差异有统计学意义(P<0.05),观察组治疗过程中不良反应发生率显著降低于对照组(2.1%vs 16.7%),差异有统计学意义(P<0.05)。结论对于肝癌TACE术后腹胀患者在常规治疗的基础上,同时加用新斯的明穴位注射治疗,可更好地增强腹胀的临床治疗效果,其具有肛门排气时间短、增加胃肠蠕动以及不良反应少等优点。

Objective To study the effect of acupoint injection of neostigmine on abdominal distension of hepatocellular carcinoma after TACE.Methods 96 patients with abdominal distension of hepatocellular carcinoma after TACE in our hospital from June 2010 to June 2012 were randomized into control group（routine treatment and nursing）and observation group（based on the control group,addition to the acupoint injection of neostigmine）,48 patients per group.The clinical curative effect,anal exhaust time,bowel sound time and adverse reactions of the two groups were compared.Results There were markedly effective of 21 patients,effective of 20 patients,ineffective of 7 patients in observation group;while were 11 patients,21 patients,16 patients in control group respectively.Compared with control group,the total effective rate was significantly increased in observation group（85.4% vs 66.7%）,there was significant difference between the two groups（P〈0.05）,and the exhaust time was obviously shortened（11.5 ± 9.9 vs 37.6 ±10.4）,the bowel sound times was significantly increased（5.9 ± 1.8 vs 0.9 ± 0.5） in observation group,there was significant difference between the two groups（P〈0.05）.The incidence of adverse reactions during the treatment was significantly decreased in observation group with statistical difference（2.1% vs 16.7%,P〈0.05）.Conclusion For the patients with abdominal distension of hepatocellular carcinoma after TACE,the acuppint injection of neostigmine based on the routine therapy can enhance the clinical effect of abdominal distension,shorten the exhaust time,increase the gastrointestinal motility with no adverse reactions,and it is worthy of clinical promotion.