Abstract
目的:比较分析肝胆患者外科手术后胃肠功能恢复的治疗方法及效果.方法:收集2013-01/2014-01水矿集团总医院外科收治的84例肝胆外科手术治疗患者临床资料,遵循随机原则,将患者分为研究组与对照组,每组例数均为42.研究组患者实施术后早期肠内营养、多潘立酮治疗、中药灌肠等手术期治疗方法,对照组患者采取补液、营养支持等常规治疗措施,比较两组患者术后肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间、治疗前后血清白蛋白(serum albumin,SAlb)、前白蛋白(prealbumin,PA)、预后营养指数(prognostic nutritional index,PNI)等指标变化情况以及术后6 d胆囊窝、肝下积液情况.结果:研究组患者肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间明显短于对照组(29.85 h±8.85 h vs 32.67 h±9.67 h,30.01 h±6.78 h vs 35.14 h±10.83 h,40.95 h±7.85 h vs 49.84 h±15.79 h,41.35 h±12.56h vs 53.86 h±1.35 h),差异具有统计学意义(P〈0.05);研究组患者治疗后SAlb、PA、PNI水平均显著升高,与治疗前比较(40.85 g/L±3.85 g/L vs 35.83 g/L±2.84 g/L,4.00 g/dL±1.35 g/dL vs 2.85 g/dL±0.75 g/dL,46.88±5.78 vs 42.15±8.83),差异具有统计学意义(P〈0.05);研究组患者治疗后SAlb、PA、PNI水平均显著高于对照组(40.85 g/L±3.85 g/L vs 33.32 g/L±2.45 g/L,4.00 g/dL±1.35 g/dL vs 1.85 g/dL±0.71 g/dL,46.88±5.78 vs 40.81±5.76),差异具有统计学意义(P〈0.05);研究组患者胆囊窝及肝下无积液率显著高于对照组(69.05%vs 40.48%),积液长径〈2 cm率、积液长径〉2 cm率均显著低于对照组(9.52%vs 26.19%、21.43%vs 33.33%),差异有统计学意义(P〈0.05).结论:将早期肠内营养、服用多潘立酮、中药灌肠等综合干预措施应用于肝胆患者外科围手术期间,有利于缩短病情恢复时间,减少胆囊窝及肝下积液,促进术后胃肠功能恢复,值得临床推广.
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