芒硝腹带脐敷促进结肠癌术后胃肠功能恢复效果观察

Observation of mirabilite-bag navel nursing in improvement of gastrointestinal dysfunction in patients after surgery of colon cancer

目的观察芒硝腹带脐敷促进结肠癌术后胃肠功能恢复的护理效果。方法选择2013年1月至2016年1月在首都医科大学附属北京中医医院外科住院的结肠癌术后患者80例，按随机数字表法分为观察组和对照组各40例。在常规术后护理基础上，对照组接受传统腹带护理，观察组接受芒硝腹带脐敷护理。对术后72 h胃肠动力恢复指标肠鸣音恢复时间、首次排气时间、术后14 d主要症状控制指标腹痛、腹胀、食欲不振，以及炎性反应指标C-反应蛋白进行观察。结果术后72 h胃肠动力恢复情况观察组肠鸣音恢复时间、首次排气时间分别为（26．2±3．3）、（39．1±8．6）h，明显低．于：对照组的（35．6±6．7）、（65．7±10．9）h，2组比较差异有统计学意义（t=9．42、11．67，P〈0．01）；术后72 h护理效果：观察组总有效率为90．0％（36／40），高于对照组的52．5％（21／40），差异有统计学意义（χ^2=12．14，P〈0．01）；术后14 d主要症状控制方面：观察组对腹痛、腹胀、食欲不振干预总有效率分别为90．0％（36／40）、95．0％（38／40）、90．0％（36／40），优于对照组的52．5％（21／40）、40．0％（16／40）、50．0％（20／40），差异有统计学意义（12=12．14、16．82、12．75，P〈0．01）；炎性反应控制方面：观察组患者干预后炎性指标C-反应蛋白为（19．73±5．68）mg／L，与干预前的（76．91±7．23）mg／L比较明显降低（t=28．43，P〈0．05），对照组干预后为（60．33±6．21）mg／L，与干预前的（77．12±8．09）mg／L比较明显降低（t=6．79，P〈0．05），2组干预后C一反应蛋白比较差异有统计学意义（t=23．085，P〈0．05）。结论芒硝腹带脐敷能够促进结肠癌术后患者胃肠动力恢复，减轻术后炎性反应，改善临床症状，符合现代快速康复外科“减少创伤应激，促进快速恢复”的理念。

Objective To observe the clinic effects of mirabilite-bag navel nursing in gastrointestinal dysfunction patients after surgery for colon cancer. Methods During Janurary 2013 to Janurary 2016, 80 hospitalized patients with gastrointestinal dysfunction after surgery for colon cancer were randomly allocated to the observation group and the control group, with 40 cases in each group. On the basis of routine nursing, the patients in the control group accepted traditional abdominal bandage nursing, patients in the observation group accepted mirabilite-bag navel nursing. Time to recovery of bowel sound and anal exhaust within 72 hours after surgery, main symptoms within 14 days after surgery such as abdominal pain, abdominal distention, loss of appetite and inflammatory marker C-react protein were observed. Results Within 72 hours after surgery： time to recovery of bowel sound and anal exhaust in the observation group were （26.2±3.3） h and （39.1±8.6） h, respectively, they were significantly shorter than the control group （35.6±6.7） h and （ 65.7± 10.9） h, respectively （t=9.42, 11.67, P 〈 0.01）. And there was a higher total effective rate of 90.0% （36/40） in the observation group compared with the total effective rate of 52.5% （21/40） in the control group （χ^2=12.14, P 〈 0.01）.Within 14 days after surgery： the total effective rats of improving main symptoms such as abdominal pain, abdominal distention and loss of appetite in the observation group were 90.0%（36/40）, 95.0%（38/40）, 90.0%（36/40）, respectively, all of which were superior to those of the control group, 52.5% （21/40）, 40.0% （16/40）, 50.0% （20/40）, respectively, X2=12.14, 16.82, 12.75, P〈 0.01）. Under the nursing interventions, patients＇ CRP level in both group were lessened, in the observation group, from （76.91±7.23） mg/L before the intervention to （19.73±5.68）mg/L after the intervention （t=28.43, P〈0.05）; in the control group, from （77.12_±8.09） mg/L before the intervention to （60.33 ± 6.21） mg/L after the intervention （t=6.79, P〈0.05）. The difference between the two groups also showed statistical significance （t=23.085, P〈0.05）. Conclusion Mirabilite- bag navel nursing can promote the recovery of gastrointestinal function, lessen inflammatory reaction, improve the main symptoms in patients after surgery of colon cancer.