艾盐包热熨与耳穴压豆联合常规疗法改善急性胆囊炎腹腔镜术后腹胀效果研究

Effect of Hot Medicinal Compress with Moxa-Salt Bag and Auricular Acupoint Pressing with Beans Combined with Routine Therapy on Relieving Abdominal Distention After Laparoscopy for Acute Cholecystitis

目的:观察在常规术后治疗与护理措施的基础上加用艾盐包热熨联合耳穴压豆改善急性胆囊炎腹腔镜胆囊切除术后腹胀的效果。方法:将140例术后腹胀患者随机分为对照组和观察组各70例。2组术后给予禁食,维持水、电解质平衡,补液、抗感染、胃肠减压等常规治疗措施,并给予常规护理措施。观察组加予艾盐包热熨中脘、神阙穴,并进行耳穴压豆。2组均连续治疗5 d。每天进行腹胀程度评分,记录腹胀的缓解情况,记录肠鸣音恢复时间、首次肛门排气时间和首次排便时间;记录术后恶心、呕吐、食欲不振、食入不化等症状的发生情况,评价护理满意度。结果:2组术后5 d腹胀程度评分逐日下降,差异均有统计学意义(P<0.01)。观察组术后2 d、3 d、4 d的腹胀程度评分均低于对照组(P<0.01)。观察组术后2~4 d的腹胀缓解率均分别高于同期对照组,差异均有统计学意义(P<0.05,P<0.01)。观察组术后肠鸣音恢复时间、首次排气时间、首次排便时间均早于对照组(P<0.01)。观察组恶心、食欲不振的发生率均低于对照组(P<0.05),护理满意度高于对照组(P<0.05)。结论:在常规术后治疗与护理措施的基础上加用艾盐包热熨联合耳穴压豆,对急性胆囊炎腹腔镜胆囊切除术后腹胀有明显的改善作用,能有效减轻术后胃肠功能紊乱,促进胃肠功能恢复,提高患者对护理措施的满意度。

Objective: To observe the effect of hot medicinal compress with moxa-salt bag and auricular acupoint pressing with beans on relieving abdominal distention after laparoscopy cholecystectomy for Acute Cholecystitis based on routine postoperative treatment and nursing. Methods: A total of 140 cases of patients with postoperative abdominal distention were randomly divided into the control group and the observation group,70 cases in each group. After surgery,both groups were given fasting, routine treatments such as measures to maintain water and electrolyte balance, fluid infusion,anti-infection treatment and gastrointestinal decompression,as well as routine nursing. The observation group was additionally treated with hot medicinal compress with moxa-salt bag at Zhongwan(GB38) and Shenque(CV8),and auricular acupoint pressing with beans. Both groups were treated for five days. Every day, the score of abdominal distention was evaluated,and the remission of abdominal distention,the recovery time of bowel sounds,the time of first anal exhaust and defecation were recorded. After surgery, the incidence of symptoms such as nausea, vomiting, poor appetite and indigestion was recorded,and the nursing satisfaction was evaluated. Results:The scores of abdominal distention during the first five days after surgery in the two groups were decreased day by day,differences being significant(P<0.01). On the 2 nd,3 rdand 4 thday after surgery, the scores of abdominal distention in the observation group were all lower than those in the control group(P<0.01). During the 2 ndto 4 thday after surgery,the remission rate of abdominal distension in the observation group was higher than that in the control group at the same period respectively,differences being significant(P<0.05,P<0.01). After surgery,the recovery time of bowel sounds,and the time of first anal exhaust and defecation in the observation group were earlier than those in the control group(P<0.01). The incidence of nausea and poor appetite in the observation group was lower than that in the control group(P<0.05). The nursing satisfaction in the observation group was higher than that in the control group(P<0.05). Conclusion: Based on the routine postoperative treatment and nursing, the therapy of hot medicinal compress with moxa-salt bag and auricular acupoint pressing with beans has significant improving effect on abdominal distention after laparoscopy cholecystectomy for acute cholecystitis,which can effectively reduce postoperative gastrointestinal dysfunction,promote the recovery of gastrointestinal function,and improve the nursing satisfaction.