加速康复外科结合穴位敷贴促进腹腔镜根治性膀胱切除术后胃肠道功能恢复的临床分析

doi:10.3969/j.issn.1005-6483.2019.05.020

摘要/Abstract

摘要： 目的:探讨加速康复外科（ERAS）结合穴位敷贴对腹腔镜根治性膀胱切除术后病人胃肠功能恢复的临床疗效。方法:膀胱癌病人100例，随机分为两组，ERAS组50例，围手术期实施ERAS相关的治疗；ERAS+穴位敷贴组50例，在ERAS的基础上实施穴位敷贴治疗。记录两组病人腹腔镜根治性膀胱切除术后的胃肠道功能恢复指标，包括肠鸣音恢复时间、首次排气和排便时间、首次进食时间、术后腹胀持续时间及腹胀程度。结果:ERAS+穴位敷贴组病人的肠鸣音恢复时间、首次排气时间、首次排便时间、首次进食时间、术后腹胀持续时间分别是（1.56±0.36）天、（3.02±0.38）天、（4.80±0.56）天、（5.40±0.48）天和（3.23±0.52）天，ERAS组病人分别为（2.25±0.52）天、（3.77±0.42）天、（5.58±0.64）天、（6.70±0.36）天和（5.00±0.66）天，两组比较差异有统计学意义（P<0.05）；在ERAS组中，术后第1天与术后第5天时病人腹胀程度比较差异有统计学意义（P＜0.05），在ERAS+穴位敷贴组中，术后第1天与术后第5天病人腹胀程度比较，差异无统计学意义（P＞0.05）。术后第5天时，ERAS+穴位敷贴组病人的腹胀程度轻于ERAS组，差异有统计学意义（P<0.05）。结论:对根治性膀胱切除术后的病人，在ERAS的基础上实施穴位敷贴治疗，可有效的促进胃肠道功能恢复。

关键词: 加速康复外科, 穴位敷贴, 根治性膀胱切除术, 胃肠道功能

Abstract: Objective:To investigate the clinical effect of enhanced recovery after surgery（ERAS）combined with acupoint application on gastrointestinal function recovery after laparoscopic radical cystectomy.Methods:100 patients with bladder cancer who were randomly divided into the ERAS group and the ERAS+acupoint application group, 50 patients in each group.The ERAS related treatments were performed in the ERAS group during perioperative period，The ERAS+acupoint application group was based on the ERAS and implemented acupoint application therapy.The recovery time of bowel sounds，the time of first anal exhaust，the time of first defecation，the time of first meal，the time of abdominal distension after surgery and the degree of abdominal distension were observed.Results:The recovery time of bowel sounds，the time of first anal exhaust，the time of first defecation，the time of first meal and the time of abdominal distension after surgery in the ERAS+acupoint application group were（1.56±0.36）d，（3.02±0.38）d，（4.80±0.56）d，（5.40±0.48）d，（3.23±0.52）d，respectively.In the above statistical time，the ERAS group were（2.25±0.52）d，（3.77±0.42）d，（5.58±0.64）d，（6.70±0.36）d，and（5.00±0.66）d，respectively.In the above statistics，ERAS+acupoint application group was significantly shorter than ERAS group（P<0.05）.In ERAS group，there was a significant statistical difference in the number of patients with abdominal distension degree between the first day after surgery and the fifth day after surgery（P<0.05）.〖JP3〗In ERAS+ acupoint application group，there was no statistical difference in the number of patients with abdom〖JP〗inal distension 〖LM〗degree between the first day after surgery and the fifth day after surgery（P>0.05）.However，on the 5th day after the operation，the ERAS+ acupoint application group had a significantly lower degree of abdominal distension than the simple ERAS group，and the difference was statistically significant（P<0.05）.Conclusion:Based on the ERAS，acupoint application was applied to the patients after radical cystectomy，which can effectively promote the recovery of gastrointestinal peristalsis function and is worthy of clinical promotion.

Key words: enhanced recovery after surgery, acupoint application, radical cystectomy, gastrointestinal function

赵蓉, 沈昊, 周家杰, 常洁, 陈诗幻. 加速康复外科结合穴位敷贴促进腹腔镜根治性膀胱切除术后胃肠道功能恢复的临床分析[J]. 临床外科杂志, 2019, 27(5): 423-426.

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