芒硝外敷脐部联合理疗治疗重症肠衰竭引起腹腔间隙综合征的临床研究

Clinical Study on the Treatment of Abdominal Space Syndrome Caused by Severe Intestinal Failure through Glauber Salt External Application of Umbilical Cord Combined with Physical Therapy

目的探讨芒硝外敷脐部联合理疗(针刺足三里,肠道走向按摩)治疗重症肠衰竭引起的腹腔间隙综合征的临床效果。方法选取我院收治的84例重症肠衰竭引起腹腔间隙综合征患者,收集时间2015年6月至2017年6月,其中42例采用腹腔减压等基础治疗(对照组)、42例采用腹腔减压等基础治疗结合芒硝外敷脐部联合理疗(针刺足三里,肠道走向按摩)治疗(研究组),对比两组患者治疗效果及各项实验室指标。结果治疗前,研究组和对照组的SBP、脉搏、呼吸、氧合指数、APACHEⅡ评分差异无统计学意义(P>0. 05);治疗后,研究组的脉搏、呼吸、APACHEⅡ评分显著的低于对照组,研究组的SBP、氧合指数显著的高于对照组,差异有统计学意义(P<0. 05)。治疗前,研究组和对照组的血清s VCAM-1、IL-6、内毒素差异无统计学意义(P>0. 05);治疗后,研究组的血清s VCAM-1、IL-6、内毒素显著的低于对照组,差异有统计学意义(P<0. 05);治疗2周后,研究组的治疗效果优于对照组,差异有统计学意义(P<0. 05)。结论芒硝外敷脐部联合理疗治疗重症肠衰竭引起腹腔间隙综合征能有效的提高治疗效果,改善患者的临床症状并降低炎症反应程度。

Objective To explore the clinical effect of Glauber salt external application of umbilical cord combined with physiotherapy（ acupuncture of Zusanli and intestinal orientation massage） in the treatment of abdominal space syndrome caused by severe intestinal failure.Methods 84 patients,from June 2015 to June 2017,with abdominal space syndrome caused by severe intestinal failure were selected in our hospital.In the 84 patients,42 cases were treated with basic treatment such as abdominal decompression（ control group）,42 cases were treated with basic treatment of abdominal decompression and Glauber salt external application of umbilical cord combined with physiotherapy（ acupuncture Zusanli and intestinal orientation massage）（ the study group）,and compare the efficacy of the two groups of patients and laboratory index.Results Before treatment,there was no statistically significant difference in SBP,pulse,respiration,oxygenation index and Apacheⅱ Ⅱ score in the study group and control croup（ P〉0. 05）.After treatment,the pulse,respiration and ApacheⅱⅡ score in the study group were significantly lower than that in the control group,the SBP,oxygenation index in the study group were significantly higher than that in control group,and the difference was statistically significant（ P 〈 0. 05）. Before treatment,there was no statistically significant difference in serum s VCAM-1,IL-6 and endotoxin in the study group and the control group（ P〉0. 05）.After treatment,the serum s VCAM-1,IL-6 and endotoxin in the study group was significantly lower than that in the control group,and the difference was statistically significant（ P〈0. 05）.After 2 weeks’ treatment,the treatment effect in the study group was better than that in the control group,and the difference was statistically significant（ P〈0. 05）.Conclusion The treatment effect of abdominal space syndrome caused by severe intestinal failure can be effectively improved by Glauber salt external application of umbilical cord combined with physiotherapy,and the treatment improves the clinical symptom and reduces the degree of inflammatory reaction.