大柴胡汤加减方贴敷胆囊区与耳穴压豆联合术后常规疗法促进胆囊炎术后康复效果分析
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Analysis of Effect of Application of Modified Prescription of Dachaihu Tang at Gallbladder Area and Auricular Point Bean- Pressing Combined with Postoperative Routine Therapy in Promoting Rehabilitation After Surgery of Cholecystitis
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    摘要:

    目的:观察大柴胡汤加减方贴敷胆囊区与耳穴压豆联合术后常规疗法促进胆囊炎术后患者康复的效果。方法:将108 例胆腑郁热型胆囊炎术后患者随机分为对照组和观察组各54 例。2 组均给予术后综合治疗与护理措施,观察组加用大柴胡汤加减方贴敷胆囊区与耳穴压豆。2 组疗程均为7 d。记录术后肠鸣音恢复时间、首次肛门排气时间及首次排便时间,应用疼痛视觉模拟评分法(VAS) 评定术后8 h、1 d、2 d、3 d 及7 d 的右上腹疼痛评分,检测术后当天及术后7 d 的C-反应蛋白(CRP)和白细胞计数(WBC),统计术后切口感染、尿潴留、粘连性肠梗阻、肝脏损伤、肺部感染等常见并发症的发生情况,记录术后体温恢复正常时间和住院时间。患者出院时自行评价对护理工作的满意度。比较2 组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。观察组术后肠鸣音恢复时间、首次排气时间、首次排便时间均早于对照组(P<0.01)。2 组术后VAS评分均逐渐下降(P<0.05),观察组术后1 d、2 d、3 d 及7 d 的VAS 评分均低于对照组(P<0.01)。术后7 d,2 组CRP 及WBC 水平均较术后1 d 降低(P<0.01),观察组术后7 d 的CRP 及WBC 水平均低于对照组(P<0.01)。观察组术后体温恢复正常时间及住院时间均较对照组缩短(P<0.01)。观察组并发症累积发生率为20.37%,低于对照组的38.89%,差异有统计学意义(P<0.05)。观察组护理满意度高于对照组(P<0.05)。结论:在术后常规治疗与护理措施基础上加用大柴胡汤加减方贴敷胆囊区和耳穴压豆干预胆囊炎术后患者,可有效促进胃肠功能恢复,减轻炎症反应与右上腹疼痛,并能减少并发症的发生,提高疗效及患者对护理工作的满意度,加快术后康复。

    Abstract:

    Abstract: Objective: To observe the effect of application of modified prescription of Dachaihu tang at gallbladder area and auricular point pressing with beans combined with postoperative routine therapy in promoting rehabilitation of patients with cholecystitis after surgery. Methods: A total of 108 cases of patients with cholecystitis of heat depression of the gallbladder type after surgery were randomly divided into the control group and the observation group, 54 cases in each group. Both groups were given postoperative comprehensive treatment and nursing measures;the observation group was additionally given application of modified prescription of Dachaihu tang at gallbladder area and auricular point pressing with beans. Both groups were treated for 7 days. The recovery time of gurgling sound, the first time of anal exsufflation and defecation after surgery were recorded. At the 8th hour,and on the 1st,2nd,3rd,and 7th days after surgery,scores of pain in right upper abdomen were evaluated via Visual Analogue Scale(VAS). On the day of surgery and the 7th day after surgery,the levels of C- reactive protein(CRP) and white blood cell count(WBC) were detected. The incidence of common complications such as incision infection, urinary retention, adhesive intestinal obstruction, the liver injury and pulmonary infection after surgery was counted. The time for temperature to return to normal and the hospitalization time after surgery were recorded. Nursing satisfaction was evaluated by patients at discharge. The clinical effect in the two groups was compared. Results: After treatment, the clinical effect in the observation group was better than that in the control group(P<0.05). In the observation group, the recovery time of gurgling sound, the first time of exsufflation and defecation after surgery were earlier than those in the control group(P<0.01). The VAS scores after surgery in the two groups were gradually decreased(P< 0.05);on the 1st,2nd,3rd,and 7th days after surgery,the VAS scores in the observation group were lower than those in the control group(P<0.01). On the 7th day after surgery, the levels of CRP and WBC in the two groups were decreased when compared with those on the 1st day after surgery(P<0.01);the two levels on the 7th day after surgery in the observation group were lower than those in the control group(P<0.01). The time for temperature to return to normal after surgery and the hospitalization time in the observation group were shortened when compared with those in the control group(P<0.01). The cumulative incidence of complications was 20.37% in the observation group,lower than that of 38.89% in the control group, the difference being significant(P<0.05). Nursing satisfaction in the observation group was higher than that in the control group (P<0.05). Conclusion:Based on postoperative routine therapy and nursing measures,the additional application of modified prescription of Dachaihu tang at gallbladder area and auricular point pressing with beans in intervening patients with cholecystitis after surgery,can effectively promote recovery of gastrointestinal function,alleviate inflammatory response and pain in right upper abdomen,reduce the incidence of complications,improve the curative effect and nursing satisfaction of patients,and accelerate postoperative rehabilitation.

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郑萍,章群波.大柴胡汤加减方贴敷胆囊区与耳穴压豆联合术后常规疗法促进胆囊炎术后康复效果分析[J].新中医,2020,52(20):35-38

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  • 在线发布日期: 2020-10-19
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