三黄承气膏穴位贴敷联合胃肠减压治疗儿童先天性心脏病术后腹胀临床研究

Clinical Study on Point Application with Sanhuang Chengqi Adhesive Plaster Combined with Gastrointestinal Decompression for Postoperative Abdominal Distension in Children with Congenital Heart Diseases

目的:观察三黄承气膏穴位贴敷联合胃肠减压治疗儿童先天性心脏病术后腹胀的临床疗效及其对血清胃动素、胃泌素的影响。方法:将110例先天性心脏病术后腹胀患儿按随机数字表法分为2组各55例。2组均给予常规治疗,对照组加用胃肠减压治疗,观察组在对照组干预方案的基础上给予三黄承气膏穴位贴敷治疗。2组均治疗3 d。比较2组临床疗效、首次排气时间、首次排便时间,比较2组治疗前、治疗12 h、治疗24 h、治疗48 h、治疗72 h腹胀程度综合评分,以及术前、术后1 d、术后3 d血清胃动素、胃泌素水平。结果:2组总有效率均为100%,差异无统计学意义(P>0.05),但显愈率对照组70.91%,观察组90.74%,差异有统计学意义(P<0.05)。2组首次排气时间及首次排便时间比较,差异均有统计学意义(P<0.05),观察组均优于对照组。2组治疗后各时间段腹胀程度综合评分分别与组内治疗前比较,差异均有统计学意义(P<0.05);2组间治疗12 h腹胀程度综合评分比较,差异无统计学意义(P>0.05),但2组间治疗24 h、治疗48 h、治疗72 h分别比较,差异均有统计学意义(P<0.05)。2组术后1 d、术后3 d血清胃动素、胃泌素分别与组内治疗前比较,差异均有统计学意义(P<0.05);2组间术后1 d、术后3 d血清胃动素、胃泌素分别比较,差异均有统计学意义(P<0.05)。结论:三黄承气膏穴位贴敷联合胃肠减压治疗儿童先天性心脏病术后腹胀临床疗效确切,可以缩短首次排气时间、首次排便时间,减轻腹胀程度综合评分并且可以促进血清胃动素、胃泌素的恢复。

Objective:To observe the clinical effect of point application with Sanhuang Chengqi Adhesive Plaster combined with gastrointestinal decompression for postoperative abdominal distension in children with congenital heart diseases and its effect on motilin and gastrin in serum.Methods:A total of110 cases of children with abdominal distension after operation for congenital heart diseases were divided into two groups according to the random number table method,with 55 cases in each group.Both groups were given routine treatment;the control group was additionally treated with gastrointestinal decompression,and the observation group was additionally treated with point application with Sanhuang Chengqi Adhesive Plaster based on the treatment of the control group.Both groups were treated for three days.The clinical effects,the first exhaust time and the first defecation time were compared between the two groups.The comprehensive scores of abdominal distension before treatment and after 12 hours,24 hours,48 hours and 72 hours of treatment,as well as the changes in motilin and gastrin in serum before operation,1 day and 3 days after operation were compared between the two groups.Results:The total effective rates were 100% in the two groups,there being no significant difference(P>0.05);the cured and markedly effective rate was 70.91% in the control group and 90.74% in the observation group,the difference being significant(P<0.05).There were significant differences being found in the comparison of the first exhaust time and the first defecation time between the two groups(P<0.05).There were significant differences being found in the comparison of the comprehensive scores of abdominal distension in each period after treatment and those before treatment in the same group(P<0.05);there was no significant difference being found in the comparison of the comprehensive scores of abdominal distension after 12 hours of treatment between the two groups(P>0.05),but there were significant differences between the two groups after 24 hours of treatment,48 hours of treatment and 72 hours of treatment(P<0.05).There were significant differences being found in the comparison of motilin and gastrin in serum 1 day and 3 days after operation and those before treatment in the same group(P<0.05);there were significant differences being found in the comparison of motilin and gastrin in serum 1 day and 3 days after operation in the two groups(P<0.05).Conclusion:Point application with Sanhuang Chengqi Adhesive Plaster combined with gastrointestinal decompression has a definite curative effect in treating postoperative abdominal distension in children with congenital heart diseases.It can shorten the first exhaust time and the first defecation time,reduce the comprehensive scores of abdominal distension,and promote the recovery of motilin and gastrin in serum.