脐针对单侧腹股沟疝修补患者术后胃肠功能紊乱的预防及对5-羟色胺的影响

Preventive Effect of Navel Needle on Postoperative Gastrointestinal Dysfunction in Patients Undergoing Unilateral Inguinal Hernia Repair and Its Impact on 5-Hydroxytryptamine

目的 探讨脐针对单侧腹股沟疝修补患者术后胃肠功能紊乱(PGID)的预防效果并探讨其机制。方法 选取2022年1—12月在河南中医药大学第一附属医院接受单侧腹股沟疝修补手术的80例患者。根据随机数字表法分为脐针组(40例)和对照组(40例)。给予两组腹股沟疝修补手术治疗,脐针组于麻醉恢复拔管后,在术后的1~3 d,每天7:00—11:00完成30 min的脐针干预,而对照组不进行处理,将两组患者术后的首次排气时间、首次排便时间、肠鸣音恢复时间、恶心发生率、呕吐发生率、腹胀发生率、切口疼痛发生率进行对比。比较两组入室时、气管导管拔管时、术后24 h、术后72 h血清5-羟色胺3(5-HT3)、5-HT4、5-HT7受体水平。结果 脐针组术后首次排气、首次排便以及肠鸣音恢复所需时间均较对照组短,且恶心、呕吐、腹胀、切口疼痛的发生率也低于对照组(P<0.05)。拔管后两组5-HT4、5-HT7受体水平差异无统计学意义(P>0.05),5-HT3受体水平差异有统计学意义(P<0.05);术后24 h对照组5-HT3、5-HT4、5-HT7受体水平低于脐针组(P<0.05);拔管后两组5-HT3、5-HT4、5-HT7均较入室时低(P<0.05);术后24 h脐针组5-HT3、5-HT4、5-HT7较拔管时升高(P<0.05)。结论 脐针可能通过促进5-HT3、5-HT4、5-HT7受体水平的恢复降低单侧腹股沟疝修补患者PGID症状。

Objective To explore the preventive effect of navel needle on postoperative gastrointestinal dysfunction(PGID)among patients who had undergone unilateral inguinal hernia repair and exploring its mechanism.Methods A total of 80 patients who had unilateral inguinal hernia repair surgery at the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January to December 2022 were chosen.By using the random number table method,they were separated into a navel needle group consisting of 40 cases and a control group also with 40 cases.Two groups were given surgical treatment for inguinal hernia repair.After anesthesia recovery and extubation,the navel needle group completed 30 minutes of umbilical needle intervention every morning from 7:00—11:00 for 1-3 days after surgery,while the control group did not receive any treatment.The time of first postoperative exhaust,first bowel movement,recovery time of bowel sounds,incidence of nausea,vomiting,abdominal distension,and incidence of wound pain between two groups were compared.The levels of serum 5-hydroxytryptamine 3(5-HT3),5-HT4,and 5-HT7 receptors of two groups at entry,after tracheal intubation,24 hours after surgery,and 72 hours after surgery were detected.Results The time of first postoperative exhaust,first defecation,recovery time of bowel sounds in the navel needle group were shorter than those in the control group,and the incidence of nausea,vomiting,abdominal distension and wound pain were lower than those of the control group(P<0.05).There was no statistically difference in the levels of 5-HT4 and 5-HT7 receptors between the two groups after extubation(P>0.05),and the difference in 5-HT3 receptor levels was statistically significant(P<0.05).The levels of 5-HT3,5-HT4 and 5-HT7 receptors in the control group were lower than those in the navel needle group 24 hours after surgery(P<0.05).After extubation,the levels of 5-HT3,5-HT4 and 5-HT7 in both groups were lower than when entering the room(P<0.05).The levels of 5-HT3,5-HT4 and 5-HT7 in the navel needle group were higher than those during extubation 24 hours after surgery(P<0.05).Conclusion Navel needle may reduce PGID symptoms in patients with unilateral inguinal hernia repair by promoting the recovery of 5-HT3,5-HT4,and 5-HT7 receptor levels.