早期穴位按压联合腹部热敷对腹部手术后患者胃肠功能恢复的影响

摘要

Objective To explore the clinical effect and application value of early acupressure combined with hot belly(hot compress on abdomen)to promote the recovery of gastrointestinal function after abdominal surgery. Methods A prospective random controlled study was conducted from January 2012 to October 2012,200 hospitalized patients having undergone abdominal surgery were randomly divided into a control group(100 cases)and an observation group(100 cases). Traditional nursing method was applied to take care of the abdominal postoperative patients in the control group,that was at post-operative 6 hours the patient may begin to turn over in bed,once 2 hours,and on the post-operative 1 day,according to the patient's disease situation,he or she may be allowed to ambulate in the room without any other additional measures,waiting for the recovery of gastrointestinal function. In the observation group, beside the traditional nursing method used in the control group,additionally,acupressure and abdominal fomentation was applied twice a day for 4 days. The postoperative bowel sound recovery time,the anus spontaneous exhaust time, the incidences of abdominal distension and intestinal obstruction were observed. Results In the observation group, the gurgling sound recovery time and anus spontaneous exhaust time were significantly shorter than those in the control group〔gurgling sound recovery time(hour):17.77±2.67 vs. 18.87±3.18,anus spontaneous exhaust time(hour):28.27±6.30 vs. 30.85±6.74,both P<0.01〕;the incidences of postoperative abdominal distention and intestinal obstruction were obviously lower than those in the control group(bloating:9.0%vs. 23.0%,intestinal obstruction:1.0% vs. 9.0%,both P<0.01). Conclusion Early application of acupressure combined with hot belly for abdominal postoperative patients can significantly promote the recovery of gastrointestinal function,that is beneficial to the reduction of the incidences of complications.%　　目的探讨早期穴位按压联合腹部热敷对促进腹部手术后胃肠功能恢复的临床效果及应用价值。方法采用前瞻性随机对照研究方法，选择2012年1月至10月本院住院治疗的200例腹部手术患者，按随机原则分为对照组和观察组，每组100例。对照组采用传统的腹部手术后护理方法，即术后6 h开始床上翻身，每2h1次，术后1d根据病情鼓励患者多下床活动，不加其他措施，等待胃肠功能恢复；观察组在对照组治疗的基础上加用穴位按压和腹部热敷，每日2次，共治疗4d。观察两组患者术后肠鸣音恢复时间、肛门自行排气时间和腹胀、肠梗阻发生率。结果观察组肠鸣音恢复时间（h）、肛门自行排气时间（h）均较对照组明显缩短（肠鸣音恢复时间：17.77±2.67比18.87±3.18，肛门自行排气时间：28.27±6.30比30.85±6.74，均P＜0.01），且术后腹胀、肠梗阻发生率均较对照组明显降低（腹胀：9.0%比23.0%，肠梗阻：1.0%比9.0%，均P＜0.01）。结论早期采用穴位按压联合腹部热敷能明显促进腹部手术后患者胃肠功能的恢复，有利于减少并发症的发生。