热敏灸对胃癌病人根治术后早期肠内营养耐受性的影响
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摘要
目的:探讨热敏灸对胃癌病人根治术后早期肠内营养耐受性的影响。方法:将60例行胃癌根治术的病人,按随机信封法随机分为对照组和观察组,每组30例。对照组采取肠内营养常规护理,观察组在肠内营养常规护理基础上在实施肠内营养前30 min给病人进行热敏灸。观察两组病人胃肠道不耐受症状发生率、肠内营养日需要量完成率、首次肛门排气时间、首次经口进食时间、术后住院时间。结果:观察组病人胃肠道不耐受症状发生率为20.69%,对照组为46.67%,两组比较差异有统计学意义(P <0.05)。两组病人肠内营养日需要量完成率比较差异有统计学意义(P<0.05),术后首次肛门排气时间、首次经口进食时间和术后住院时间差异都有统计学意义(P<0.01)。结论:热敏灸能降低胃癌病人术后早期肠内营养胃肠道不耐受症状的发生率,提高病人肠内营养日需要量完成率,热敏灸还能缩短术后首次排气时间和首次进食时间及术后住院时间。
Objective: To explore the effects of thermal moxibustion on early enteral nutrition tolerance in patients with gastric cancer after radical resection. Methods: Sixty patients who underwent radical gastrectomy were randomly divided into control group and observation group by random envelope method, with 30 patients in each group.Patients in the control group received enteral nutrition and routine care, and those in the observation group were treated with thermal moxibustion for 30 minutes before the enteral nutrition. The incidence of gastrointestinal intolerance, the completion rate of daily enteral nutrition requirements, the time of first anal exhaust, the time of first oral intake, and the postoperative hospital stay were observed. Results: The incidence of gastrointestinal intolerance was 20.69% in the observation group and 46.67% in the control group, and the difference between the two groups was statistically significant(P < 0.05). Significant differences were found between 2 groups in terms of the completion rate of daily requirement of evteral nutrition(P < 0.05), the time of first postoperative anal exhaust time, the time of first oral feeding time, and the postoperative hospitalization stay(P < 0.01). Conclusion: In patients with gastric cancer after radical resection, thermal moxibustion could decrease the incidence of early postoperative enteral nutritional intolerance,improve the completion rate of daily nutrient requirements, shorten the time of first postoperative exhaust and first feeding time, and reduce the duration of postoperative hospital stay.
Objective: To explore the effects of thermal moxibustion on early enteral nutrition tolerance in patients with gastric cancer after radical resection. Methods: Sixty patients who underwent radical gastrectomy were randomly divided into control group and observation group by random envelope method, with 30 patients in each group.Patients in the control group received enteral nutrition and routine care, and those in the observation group were treated with thermal moxibustion for 30 minutes before the enteral nutrition. The incidence of gastrointestinal intolerance, the completion rate of daily enteral nutrition requirements, the time of first anal exhaust, the time of first oral intake, and the postoperative hospital stay were observed. Results: The incidence of gastrointestinal intolerance was 20.69% in the observation group and 46.67% in the control group, and the difference between the two groups was statistically significant(P < 0.05). Significant differences were found between 2 groups in terms of the completion rate of daily requirement of evteral nutrition(P < 0.05), the time of first postoperative anal exhaust time, the time of first oral feeding time, and the postoperative hospitalization stay(P < 0.01). Conclusion: In patients with gastric cancer after radical resection, thermal moxibustion could decrease the incidence of early postoperative enteral nutritional intolerance,improve the completion rate of daily nutrient requirements, shorten the time of first postoperative exhaust and first feeding time, and reduce the duration of postoperative hospital stay.
引文
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[13] Vicario M, Alonso C, Guilarte M, et a1. Chronic psychosocial stress induces reversible mitochondrial damage and corticotrophinreleasing factor receptor type-I upregulation in the rat intestine and IBS—like gut dysfunetion. Psychoneuroendocrinology, 2012, 37(1):65-77.
[14]黄晓旭,许力,朱家胜,等.早期肠内营养对胃癌患者术后并发症的影响.皖南医学院学报,2013,32(6):466-468.
[15]谢荣臻,曾祥福,邓伟,等.术后早期肠内营养在胃癌病人治疗中的临床观察.肠外与肠内营养,2017,24(4):225-228.
[2] Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China,2015. CA Cancer J Clin, 2016, 66(2):115-132.
[3]吴丽红,张晓琴.胃癌术后病人早期肠内营养肠道耐受性研究进展.护理研究,2016,30(10):3457-3460.
[4]翁延宏,顾国胜,朱永龙,等.胃癌病人术后早期肠内营养不耐受的风险因素及对预后影响.肠外与肠内营养, 2017(3):155-158.
[5]孙令军,杨文,郭彦层,等.腧穴热敏化悬灸治疗腹泻型肠易激综合征临床研究.广州中医药大学学报,2016,33(3):338-341.
[6]王士源,徐亚莉,高原,等.热敏灸治疗功能性消化不良疗效观察.上海针灸杂志,2016,35(5):538-540.
[7]康梦如.热敏灸疗法对腹部手术后胃肠功能恢复的影响.广州中医药大学学位论文, 2014.
[8] Juan Wang,Ming Yi,Chan Zhang, et al. Cortical activities of heatSensitization responses in suspended moxibustion:an EEG source analysis with sLORETA.Cogn Neurodyn,2015,9(6):581-588.
[9]吴璐一,翁志军,窦传字,等.针灸对IBS内脏痛大鼠结肠肌间神经丛神经元P2X2受体表达的调节.世界中西医结合杂志,2014,9(6):601-604.
[10]何凌,姜国平,刘华,等.腧穴热敏化艾灸对慢性腹泻脾肾亏虚证患者胃泌素及胃动素的影响.中国中西医结合杂志,2012,32(4):460-463.
[11] Liao F, Zhang C, Bian Z, et al. Characterizing heat-sensitization responses in suspended moxibustion with high-density EEG. Pain Med,2014,15(8):1272-1281.
[12] Wang J, Yi M, Zhang C, et al. Cortical activities of heatSensitization responses in suspended moxibustion:an EEG source analysis with slORETA. Cogn Neurodyn,2015,9(6):581-588.
[13] Vicario M, Alonso C, Guilarte M, et a1. Chronic psychosocial stress induces reversible mitochondrial damage and corticotrophinreleasing factor receptor type-I upregulation in the rat intestine and IBS—like gut dysfunetion. Psychoneuroendocrinology, 2012, 37(1):65-77.
[14]黄晓旭,许力,朱家胜,等.早期肠内营养对胃癌患者术后并发症的影响.皖南医学院学报,2013,32(6):466-468.
[15]谢荣臻,曾祥福,邓伟,等.术后早期肠内营养在胃癌病人治疗中的临床观察.肠外与肠内营养,2017,24(4):225-228.