不同时间点耳穴埋籽对胃癌术后患者胃动素及胃肠功能的影响

Effects of auricular acupoint seed implantation at different time on motilin and gastrointestinal function in postoperative patients with gastric cancer

目的探讨不同时间点耳穴埋籽对胃癌术后患者胃动素及胃肠功能的影响。方法选择2016年1月~2018年4月普外科拟行胃癌根治术患者104例,随机分为两组。两组患者均在全麻下行开放性胃癌根治术,术后均予以围手术期常规干预。观察组患者术前2d开始耳穴埋籽治疗,对照组患者术后6h开始耳穴埋籽治疗。观察两组患者术前2d与术后2d后血清MTL水平变化,并比较胃肠功能恢复情况及术后并发症的发生率。结果术后2d,两组患者血清MTL水平较术前2d明显下降(P<0.05或P<0.01),且观察组患者MTL水平下降幅度少于对照组(P<0.05)。观察组患者术后肠鸣音恢复时间、首次肛门排气时间、首次肛门排便时间明显短于对照组,腹胀发生率明显低于对照组(P<0.05);观察组患者术后并发症发生率明显低于对照组(χ2=4.52,P<0.05)。结论耳穴埋籽用于胃癌术后患者可促进胃肠功能蠕动的恢复,减少术后并发症的发生,其作用机制与其促进MTL的分泌、减少术后MTL下降幅度密切相关,且术前2d预先予以耳穴埋籽效果更好。

Objective To investigate the effects of auricular acupoint seed implantation at different time points on motilin and gastrointestinal function in patients with gastric cancer. Methods 104 patients with radical gastrectomy from January 2016 to April 2018 were randomly divided into two groups. Both groups of patients were treated with radical gastrectomy under general anesthesia, and all patients were given routine perioperative intervention. The patients in the observation group were given auricular acupoint seed implantation 2 days before surgery, and the patients in the control group were given auricular acupoint seed implantation 6 hours after surgery. Serum MTL levels were observed 2 days before and 2 days after surgery, and the recovery of gastrointestinal function and the incidence of postoperative complications were compared. Results At 2 days after operation, serum MTL levels in the two groups were significantly lower than those 2 days before surgery(P<0.05 or P<0.01), and the MTL level in the observation group decressed less than that in the control group(P<0.05). The recovery time of postoperative bowel sounds, the first anal exhaust time, and the first anal defecation time were significantly shorter in the observation group than those in the control group, and the incidence of abdominal distension was significantly lower than that in the control group(P<0.05). The incidence of postoperative complications was significantly lower in the observation group than in the control group(χ2=4.52, P<0.05). Conclusion In patients after gastric cancer surgery, auricular seed can promote the recovery of gastrointestinal motility and reduce the occurrence of postoperative complications. The mechanism is closely related to the promotion of MTL secretion and prevention of postoperative MTL decline. The effect of seed implantation at 2 days before surgery is better.