大黄鼻饲联合芒硝腹部外敷治疗脓毒症胃肠功能障碍的效果研究

Study on effect of rhubarb nasal feeding and mirabilite abdominal external application on septic gastrointestinal dysfunction

目的探讨大黄鼻饲联合芒硝腹部外敷治疗脓毒症胃肠功能障碍的临床效果。方法74例脓毒症胃肠功能障碍患者,按治疗方法不同分为常规组和试验组,各37例。常规组患者采用常规法治疗,试验组患者在常规组基础上采用大黄鼻饲联合芒硝腹部外敷治疗。比较两组患者治疗前后胃肠道症状评定量表(GSRS)评分、急性生理学与慢性健康状况系统Ⅱ(APACHEⅡ)评分、腹内压及腹围。结果治疗前,两组患者GSRS评分、APACHEⅡ评分、腹内压及腹围比较差异均无统计学意义(P>0.05);治疗后,试验组GSRS评分(30.24±2.37)分高于常规组的(21.84±2.15)分,APACHEⅡ评分(14.13±1.12)分、腹内压(14.04±1.08)mm Hg(1 mm Hg=0.133 kPa)低于常规组的(16.45±1.39)分、(15.67±1.42)mm Hg,腹围(93.58±3.74)cm明显小于常规组的(97.53±4.83)cm,差异具有统计学意义(P<0.05)。结论采用大黄鼻饲联合芒硝腹部外敷治疗脓毒症胃肠功能障碍患者,能获得较为理想的治疗效果,不仅能改善患者的胃肠功能,还能降低患者的腹内压,减小腹围,有助于提高患者的生活质量与生存质量,值得临床应用。

Objective To discuss the clinical effect of rhubarb nasal feeding and mirabilite abdominal external application on septic gastrointestinal dysfunction.Methods A total of 74 patients with septic gastrointestinal dysfunction were divided into conventional group and experimental group according to different treatment methods,with 37 cases in each group.The conventional group was treated with conventional method,and the experimental group was treated with rhubarb nasal feeding and mirabilite abdominal external application on the basis of the conventional group.The gastrointestinal symptom rating scale(GSRS)scores,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores,intra-abdominal pressure and abdominal circumference were compared between the two groups before and after treatment.Results Before treatment,the differences in GSRS score,APACHE Ⅱ score,intra-ahdominal pressure and abdominal cirrumference between the two groups were not statistically significant(P>0.05).After treatment,GSRS score(30.24±2.37)points of the experimental group was significantly higher than(21.84±2.15)points of the conventional group,APACHE Ⅱ score(14.13±1.12)points and intra-ahdominal pressure(14.04±1.08)mm Hg(1 mm Hg=0.133 kPa)were significantly lower than(16.45±1.39)points and(15.67±1.42)mm Hg of the conventional group,and abdominal circumference(93.58±3.74)cm was significantly less than(97.53±4.83)cm of the conventional group.All the difference was statistically significant(P<0.05).Conclusion Combination of rhubarb nasal feeding and mirabilite abdominal external application has ideal therapeutic effect on patients with septic gastrointestinal dysfunction,and it can not only improve patients'gastrointestinal function,but also can reduce patients'intra-ahdominal pressure and abdominal circumference,help improve patients*quality of life and survival quality,which is worthy of clinical application.