超声评估电针改善危重症患者胃动力功能的临床研究

Ultrasound evaluation of electroacupuncture for improving gastric motility in critical patients

目的:探讨超声在胃动力评估的作用及电针治疗危重症胃肠功能障碍患者胃动力功能疗效。方法:纳入2016-01-2017-10期间我院综合ICU、急诊ICU病房危重病胃肠功能障碍患者60例,随机分为电针治疗组30例和常规治疗组30例,分别在治疗过程中第0、3、7天测定超声胃动力检查:胃排空时间(GET)、胃窦收缩频率(ACF)、胃窦收缩幅度(ACA)、胃窦运动指数(MI);APACHEⅡ评分;胃肠功能障碍评分;24h胃残留量;腹内压。结果:治疗第7天电针治疗组较常规治疗组,可明显改善患者超声监测下胃排空时间及胃窦收缩频率,而对胃窦收缩幅度及胃窦运动指数两组差异无统计学意义;治疗第7天电针治疗组较常规治疗组,可明显减少24h胃残留量、降低腹内压、改善APACHEⅡ评分,对胃肠功能障碍评分两组差异无统计学意义。结论:电针可改善危重症患者胃动力功能,超声可作为评估针灸治疗胃动力功能障碍疗效的实时、床旁、无创、经济、安全、客观辅助检查。

Objective：To investigate the role of ultrasound in the assessment of gastric motility and the therapeutic effect of electroacupuncture on gastric motility in patients with critically ill gastrointestinal dysfunction.Method：60 patients with gastrointestinal dysfunction in ICU and emergency ICU wards of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2016 to October 2017 were randomly divided into group of 30 cases treated with electroacupuncture and another group of 30 cases treated with conventional treatment.Ultrasound gastric motility examination（GET,ACF,ACA and MI）,APACHEⅡ score,gastrointestinal dysfunction score,24-hour gastric residual andintra-abdominal pressure was performed on day 0,day 3 and day 7 of treatment.Result：On the 7th day,The electroacupuncture group showed a significant improvement in the gastric emptying time and antral contraction frequency compared with the conventional treatment group,while there was no significant difference in the antral contraction amplitude and motility index between the two groups.Compared with the conventional treatment group,the electroacupuncture group could significantly reduce the gastric residual volume in 24 hours and the intra-abdominal pressure,in the meantime,improve the APACHE-II score on the 7th day.There was no significant difference in the score of gastrointestinal dysfunction between the two groups.Conclusion：Electroacupuncture is able to improve gastric motility in critically ill patients.Ultrasound can be employed as a real-time,bedside,noninvasive,economical,safe and objective auxiliary examination to evaluate the therapeutic effect of acupuncture on gastric motility dysfunction.