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                    1. 当前位置: 代写一篇论文多少钱 > 医学论文 > 腹部术后腹胀患者采用中药灌肠和新斯的明的效果

                      腹部术后腹胀患者采用中药灌肠和新斯的明的效果

                      时间:2019-03-04 11:11作者:周小琴 王秋丽
                      本文导读:这是一篇关于腹部术后腹胀患者采用中药灌肠和新斯的明的效果的文章,腹部外科手术后常见的一种并发症是腹胀,如果不及时治疗,影响患者的恢复,严重者出现伤口感染、肠黏膜损伤、应激性肠粘连等,增加患者的身心痛苦,影响治疗质量。积极消除外科手术后腹胀,促进患者的胃肠功能尽早恢

                      棋牌大全下载安装   FUBUWAIKESHOUSHUHOUCHANGJIANDEYIZHONGBINGFAZHENGSHIFUZHANG,RUGUOBUJISHIZHILIAO,YINGXIANGHUANZHEDEHUIFU,YANZHONGZHECHUXIANSHANGKOUGANRAN、CHANGNIANMOSUNSHANG、YINGJIXINGCHANGZHANLIANDENG,ZENGJIAHUANZHEDESHENXINTONGKU,YINGXIANGZHILIAOZHILIANG。JIJIXIAOCHUWAIKESHOUSHUHOUFUZHANG,CUJINHUANZHEDEWEICHANGGONGNENGJINZAOHUIFUJUYOUZHONGYAOYIYI。XIYITONGCHANGCAIQUWEICHANGJIANYA、JINSHI、XIACHUANGHUODONGDENGFANGSHI,CUJINSHUHOUCHANGRUDONGDEHUIFU,XIAOGUOBUGOULIXIANG。ZHONGYAOGUANCHANGWEIZHONGYITESELIAOFA,KEYIHUANJIEFUZHANG,CUJINCHANGRUDONG[1]。BENYUANCAIYONGZHONGYAOGUANCHANGPEIHEXINSIDEMINGXUEWEIZHUSHEDUI2016NIAN12YUE—2018NIAN12YUESHISHIFUBUWAIKESHOUSHUHOUCHUXIANFUZHANGHUANZHEJINXINGGANYU,GUANCHAZHILIAOXIAOGUO,XIANBAODAORUXIA。

                        1、 临床资料

                        1.1、 一般资料

                      棋牌大全下载安装   XUANQUYUBENYUAN110LIJINXINGFUBUWAIKESHOUSHUCHUXIANSHUHOUZHANGQIDEHUANZHE,SHIJIANFANWEIWEI2015NIAN12YUE—2018NIAN12YUE。ANSUIJISHUZIBIAOFAFENCHENGLIANGZU,MEIZU55LI。DUIZHAOZUZHONGNANXING31LI,NVXING24LI;NIANLING17~76SUI,PINGJUNNIANLING(50.6±10.3)SUI;QIZHONGMANXINGDANNANGYANSHOUSHU16LI,WEICHANGSHOUSHU39LI。GUANCHAZUZHONGNANXING32LI,NVXING23LI;NIANLING16~77SUI,PINGJUNNIANLING(50.9±10.7)SUI;QIZHONGMANXINGDANNANGYANSHOUSHU15LI,WEICHANGSHOUSHU40LI。LIANGZUHUANZHEDEXINGBIE、NIANLINGDENGYIBANZILIAOWUXIANZHECHAYI(P>0.05)。

                        1.2、 诊断标准

                        CANZHAO《XIYIWAIKEXUE》[2]ZHONGFUBUSHOUSHUHOUFUZHANGDEXIANGGUANZHENDUANBIAOZHUN。

                        1.3 、纳入标准

                        SUOYOUHUANZHEJINXINGFUBUWAIKESHOUSHU,SHUHOUQUEZHENFUZHANGQI;NIANLING18~80SUI;HUANZHEJIJIASHUDUIBENLINCHUANGGUANCHAZHIQING。

                        1.4 、排除标准

                      棋牌大全下载安装   GUANCHANGHOUZAICHANGGUANNEIGUANCHANGYEBUNENGBAOLIU15 minYISHANG;BUPEIHEZHILIAOGONGZUOHUANZHE;FUBUSHOUSHUHOUJULIBENCIFABINGDAYU2ZHOU;YOURENZHIZHANGAIHUOZHEJINGSHENJIBINGHUANZHE;YOUXIN、GAN、SHENDENGYANZHONGQIZHIXINGJIBING;GUOMINTIZHIHUODUIBENGUANCHAYONGYAOGUOMINZHE。

                        2 、方法

                        2.1 、治疗方法

                        对两组患者进行常规护理和治疗,患者术后嘱其禁食,进行静脉补液,给予营养支持,维持酸碱平衡、水电解质平衡及抗炎对症处理。常规护理措施:向患者介绍有关腹胀气的相关知识,原因、治疗方式、注意事项等,指导患者合理饮食,科学活动等。对照组给予新斯的明足三里穴位注射;患者采取坐位或者仰卧位,选取双侧足三里,常规消毒,5 m L注射器抽取新斯的明注射液(上海信谊金朱药业有限公司,国药准字H31022770)1 mg,针刺入足三里,患者有酸胀、麻木感后回抽无血,将药物注入,迅速拔针,轻揉1~2 min,疗程3 d。观察组在对照组的基础上,采用中药灌肠治疗。中药由党参20 g,白术15 g,茯苓15 g,生姜15 g,半夏15 g,莱菔子15 g,枳实15 g,厚朴15 g,生大黄15 g(后下),桃仁20 g,炙甘草10 g,加水煎熬。中药灌肠操作:患者取左侧卧位,输液架上挂灌肠筒,灌肠袋中的药液,保持温度38~40℃。石蜡油管端润滑,逐渐向患者肛门插入约26~29 cm,缓慢灌入药液。结束后患者抬高臀部10~15 cm,缓慢拔出肛管。患者采取平卧姿势,尽量保留1 h再排出。每日1次,连续治疗3日。
                       

                      腹部术后腹胀患者采用中药灌肠和新斯的明的效果
                       

                        2.2、 疗效标准

                        CANZHAO《XIYIWAIKEXUE》[2]ZHONGFUBUSHOUSHUHOUFUZHANGDEXIANGGUANNEIRONGNIDING。ZHIYU:HUANZHEFUZHANGZHENGZHUANGXIAOSHI,GANGMENPAIQI、PAIBIANSHUNCHANG,CHANGMINGYINHUIFUZHENGCHANG;HAOZHUAN:HUANZHEFUZHANGZHENGZHUANGJIANQING,CHANGMINGYINHUIFUDANJIAORUO,GANGMENSUIPAIQI、PAIBIANDANQIANSHUNCHANG;WUXIAO:HUANZHEFUZHANGZHENGZHUANGWUHUANJIE,CHANGMINGYINWEIHUIFU,GANGMENWEIPAIQI、PAIBIAN。

                        2.3、 观察指标

                        GUANCHALIANGZUHUANZHEDECHANGDAOGONGNENGHUIFUQINGKUANG:BAOKUOCHANGMINGYINHUIFUSHIJIAN、SHOUCIGANGMENPAIQISHIJIAN

                        2.4、 统计方法

                      棋牌大全下载安装   SUOYOUSHUJUJUNCAIYONGSPSS20.0RUANJIANJINXINGTONGJIFENXI,YONGχ2JIANYANJINXINGJISHUZILIAOJIANBIJIAOFENXI;JILIANGZILIAOYONG(±s)BIAOSHI,YONGtJIANYANJINXINGJILIANGZILIAOJIANBIJIAOFENXI。P<0.05BIAOSHICHAYIJUYOUTONGJIXUEYIYI。

                        3 、结果

                        3.1、 两组患者治疗效果的比较

                      棋牌大全下载安装   ZHILIAOHOUGUANCHAZUZONGYOUXIAOLVWEI96.4%(53/55),DUIZHAOZUZONGYOUXIAOLVWEI78.2%(43/55),LIANGZUJIANBIJIAOCHAYIXIANZHE(P<0.05),JIANBIAO1。

                        表1 两组患者治疗效果比较[例(%)]
                      表1 两组患者治疗效果比较[例(%)]

                        ZHU:YUDUIZHAOZUBIJIAO,#P<0.05

                        3.2、 两组患者肠道功能恢复情况比较

                        GUANCHAZUHUANZHEDECHANGMINGYINHUIFUSHIJIANMINGXIANDUANYUDUIZHAOZU,GUANCHAZUHUANZHEDESHOUCIPAIQISHIJIANMINGXIANZAOYUDUIZHAOZU,LIANGZUSHUJUCUNZAIXIANZHECHAYI(P<0.05),JIANBIAO2。

                        表2 两组患者肠道功能恢复情况比较(±s,h)
                      表2 两组患者肠道功能恢复情况比较(±s,h)

                        ZHU:YUDUIZHAOZUBIJIAO,#P<0.05

                        4、 讨论

                      棋牌大全下载安装   FUBUSHOUSHUHOUFUZHANGHEDUOZHONGYINSUYOUGUAN,BIRUWEICHANGDAOJIQIGUODUO、YINSHI、JINGSHENDENG,YINCIYAOCAIQUHELIZHILIAO、JINGXINHULI、YUFANGCUOSHIXIANGJIEHEDEZONGHEFANGSHI,JIANGDIFUBUWAIKESHOUSHUSHUHOUFUZHANGDEFENGXIAN。XINSIDEMINGSHIYIZHONGDANJIANZHIMEIYIZHIJI,NENGXINGFENWEICHANGDAOPINGHUAJI,SHIWEICHANGRUDONGJIAKUAI、CUJINPAIQI、PAIBIANJIWEICHANGGONGNENGHUIFU[3]。YOUYANJIUZHENGSHI,XINSIDEMINGNENGZENGQIANGWEICHANGSHUHOUHUANZHEHEZHENGCHANGRENDEWEICHANGDONGLI[4]。CAIYONGZUSANLIXUEWEIZHUSHELIAOFA,KEYIXIAOZHILIQI,JIFAJINGLUO,DIAOJIECHANGWEIGONGNENG。

                      棋牌大全下载安装   ZHONGYILILUNRENWEI,FUBUWAIKESHOUSHUHUANZHEYOUYUYUANFAJIBINGJISHOUSHUJINRENSUNSHANGFUBUDEMAILUO,DAOZHIQIZHIXUEYU,ZANGFUGONGNENGSHIDIAO,FUQIBUTONG,QIJISHENGJIANGSHICHANGCHANSHENGFUZHANG,BUTONGZETONGGUFUTONG,FUQIBUTONG、QINIYUSHANGZEDABIANBUTONG、EXIN。ZHILIAODANGJIANPIXINGQIDAOZHI、QUYULISHIXIAOZHANG。ZHONGYAOGUANCHANGLIAOFASHIZHONGYITESELIAOFAZHIYI,GAILIAOFATONGGUOZHICHANGJIYAOGENGJIASHIHESHUHOUBAOLIUWEIGUAN,JIANGDIWEICHANGYALIDEHUANZHE,BUHUIDUIWEIBUCHANSHENGFUZUOYONG。ZHICHANGBIZUZHIYOUBANTOUMO,KEYIXUANZEXINGDIJINXINGPAIXIEHEXISHOU,ZHONGYAOBAOLIUGUANCHANGTONGGUOZHICHANGJIYAO,CUJINYAOWUDEXISHOU。YIFANGMIANYAOWUZHIJIEJINRUTIXUNHUANZHONG,BUJINGGUOXIAOHUAMEIFENJIE、POHUAI,BIMIANGANZANGDESHOUGUOXIAOYING,SHENGWULIYONGDUGAO[5];LINGYIFANGMIAN,YEYOUJUBUZHILIAODEZUOYONG。BENLINCHUANGGUANCHAZHONGDEGUANCHANGZHONGYAOFANGZHONGDANGCAN、BAISHU、FULINGYIQIJIANPIHUASHI;SHENGJIANGYUBANXIAJIANGNIHEZHONGXIAOPI;ZHISHIPOQIXIAOJICHUPI;HOUPOZAOSHIXIAQICHUMAN;LAIFUZIXINGQIXIAOZHANG;DAHUANGXIERETONGBIAN、ZHUYUTONGJING;TAORENRUNCHANGTONGBIAN、HUOXUEQUYU;ZHIGANCAOYOUBUPIHEWEI、DIAOHEZHUYAO。ZHUYAOXIANGHESHIDEPIWEIJIANYUN,QIJISHUNCHANG,YUXUEJIANXIAO,FUQIDETONG,DABIANDEXIA,WEICHANGGONGNENGDEYIHUIFU,FUZHANGXIAOCHU。

                      棋牌大全下载安装   BENGUANCHAJIEGUOXIANSHI:YUDUIZHAOZUXIANGBI,PEIHEZHONGYAOGUANCHANGZHILIAODEGUANCHAZU,ZHILIAOHOUZONGYOUXIAOLVMINGXIANGAODUIZHAOZU(P<0.05);GUANCHAZUHUANZHESHOUCIPAIQISHIJIAN、CHANGMINGYINHUIFUSHIJIANJUNMINGXIANDUANYUDUIZHAOZU。GAIJIEGUOTISHIFUBUWAIKESHOUSHUSHUHOUFUZHANGDEHUANZHE,TONGGUOZHONGYAOGUANCHANGHEHULIGANYU,NENGGOUYOUXIAOTIGAOZHILIAOXIAOGUO,CUJINHUANZHEDEWEICHANGGONGNENGJINZAOHUIFU。

                        参考文献

                        [1] 曹立幸,伍嘉仪,蒋志,等.中医外治法促进胃肠功能恢复的研究进展[J].广州中医药大学学报,2018,35(6):1147-1152.
                        [2] 李乃卿.西医外科学[M].北京:中国中医药出版社,2003:425.
                        [3] 谭黄业,陈辉.新斯的明足三里注射治疗腹部手术后腹胀156例[J].临床军医杂志,2004,32(6):89-90.
                        [4]Von derohe M R,Hanson R B,Camilleri M. Comparison of simultaneous recordings of human colonic contractins by manometry and barostat[J]. Neurogastroenterol Motil,1994,6:213.
                      棋牌大全下载安装   [5] 卓小慧,谢艳珠,符华丽.综合护理对腹部外科手术患者术后肠胃功能恢复的影响研究[J].现代诊断与治疗,2017,28(5):962-964.

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