【摘要】：目的:觀察分析腸內(nèi)外營養(yǎng)結(jié)合針灸在術(shù)后胃癱治療中的療效。方法:收集并分析2005年1月至2016年10月因胃癌在皖南醫(yī)學(xué)院第一附屬醫(yī)院行根治性胃大部切除術(shù)后并發(fā)胃癱的患者資料,術(shù)后胃癱患者按有無接受腸內(nèi)外營養(yǎng)和針灸的治療分為腸內(nèi)營養(yǎng)結(jié)合針灸組(n=12)、腸外營養(yǎng)結(jié)合針灸組(n=9)和單純腸內(nèi)營養(yǎng)組(n=9)。比較三組患者術(shù)后住院天數(shù)和術(shù)后淋巴細胞計數(shù)、血紅蛋白、總蛋白、白蛋白的差異。結(jié)果:腸內(nèi)營養(yǎng)結(jié)合針灸組、腸外營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者的術(shù)后住院天數(shù)分別為24.83±8.66d、35.78±11.69d、26.67±9.04d;三組間比較差異有統(tǒng)計學(xué)意義(p0.05),兩兩間比較顯示:腸內(nèi)營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者術(shù)后住院天數(shù)均比腸外營養(yǎng)結(jié)合針灸組明顯減少,差異有統(tǒng)計學(xué)意義(p0.05);腸內(nèi)結(jié)合針灸組術(shù)后住院天數(shù)比單純腸內(nèi)營養(yǎng)組稍減少,但差異無統(tǒng)計學(xué)意義(p0.05)。術(shù)后1周三組患者的淋巴細胞計數(shù)、血紅蛋白、總蛋白及白蛋白水平比較,差異無統(tǒng)計學(xué)意義,兩組間比較差異也無統(tǒng)計學(xué)意義。術(shù)后2周腸內(nèi)營養(yǎng)結(jié)合針灸組和單純腸內(nèi)營養(yǎng)組患者的白蛋白均比腸外營養(yǎng)結(jié)合針灸組明顯增多,差異有統(tǒng)計學(xué)意義;此外,單純腸內(nèi)營養(yǎng)組術(shù)后2周的血紅蛋白水平明顯高于腸外營養(yǎng)結(jié)合針灸組。腸內(nèi)營養(yǎng)結(jié)合針灸組患者術(shù)后2周的總蛋白和白蛋白比術(shù)后1周顯著增多,差異有統(tǒng)計學(xué)意義;單純腸內(nèi)營養(yǎng)組患者術(shù)后2周的血紅蛋白和白蛋白比術(shù)后1周明顯增多,差異有統(tǒng)計學(xué)意義;而腸外營養(yǎng)結(jié)合針灸組患者術(shù)后第1周與術(shù)后2周的各項營養(yǎng)指標(biāo)比較,差異無統(tǒng)計學(xué)意義。結(jié)論:腸內(nèi)營養(yǎng)結(jié)合針灸及單純腸內(nèi)營養(yǎng)可明顯改善術(shù)后胃癱癥狀。腸內(nèi)營養(yǎng)結(jié)合針灸與單純腸內(nèi)營養(yǎng)相比,術(shù)后住院天數(shù)的減少和營養(yǎng)狀況的改善不明顯。
[Abstract]:Objective: to observe and analyze the curative effect of enteral nutrition combined with acupuncture in the treatment of postoperative gastroparesis. Methods: data of patients with gastric cancer complicated with gastroparesis after radical subtotal gastrectomy in the first affiliated Hospital of Southern Anhui Medical College from January 2005 to October 2016 were collected and analyzed. Patients with postoperative gastroparesis were divided into three groups: enteral nutrition combined with acupuncture and moxibustion (n / 12), parenteral nutrition combined with acupuncture and moxibustion (n / 9) and simple enteral nutrition (n / 9). The differences of postoperative hospitalization days, lymphocyte count, hemoglobin, total protein and albumin were compared among the three groups. Results: the postoperative hospitalization days of patients in enteral nutrition combined with acupuncture group, parenteral nutrition combined with acupuncture group and simple enteral nutrition group were 24.83 鹵8.66 days (35.78 鹵11.69 days) and 26.67 鹵9.04 days respectively. The difference among the three groups was statistically significant (p0.05). The results showed that the days of hospitalization in enteral nutrition combined with acupuncture group and simple enteral nutrition group were significantly lower than those in parenteral nutrition combined with acupuncture group. The difference was statistically significant (p0.05). The days of postoperative hospitalization in the combined enteral acupuncture group were slightly less than those in the simple enteral nutrition group, but the difference was not statistically significant (p0.05). There was no significant difference in lymphocyte count, hemoglobin, total protein and albumin levels between the two groups. Two weeks after operation, the albumin levels in the enteral nutrition combined with acupuncture group and simple enteral nutrition group were significantly higher than those in the parenteral nutrition combined with acupuncture group, and the difference was statistically significant. In addition, the hemoglobin level in simple enteral nutrition group was significantly higher than that in parenteral nutrition combined with acupuncture group 2 weeks after operation. The total protein and albumin in the group of enteral nutrition combined with acupuncture and moxibustion at 2 weeks after operation were significantly higher than that at 1 week after operation, and the difference was statistically significant. The levels of hemoglobin and albumin in simple enteral nutrition group at 2 weeks after operation were significantly higher than those at 1 week after operation, and the difference was statistically significant. However, there was no significant difference in nutritional indexes between the first week and the second week after operation in the group of parenteral nutrition combined with acupuncture and moxibustion. Conclusion: enteral nutrition combined with acupuncture and simple enteral nutrition can obviously improve the symptoms of postoperative gastroparesis. Compared with simple enteral nutrition, the days of hospitalization and the improvement of nutritional status were not obvious in the combination of enteral nutrition and acupuncture.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R656

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