| BackgroundGastrointestinal dysfunction is the common postoperative complication of cardiac surgery. At home and abroad, many studies show that traditional Chinese medicine External Therapy,such as pressing ear acupoint or acupuncture, can improve the postoperative gastrointestinal function and reduce or ameliorate the symptom of nausea,vomiting,abdominal distention, astriction and so on, and so as to reduce the mortality rate during perioperative period in cardiac surgery. Early treatment is the key of postoperative recovery of gastrointestinal function. The recovery of gastrointestinal function for heart surgery has important significance to maintain the stable hemodynamics, improve respiratory function, reduce postoperative complications. There has been a lot of research in the postoperative recovery of gastrointestinal function disorder with traditional Chinese and western medicine, and also many different means in the treatment.But at present the much of the past research is for the abdominal surgery. As the adverse Reaction of the western medicine treatment itself, such as the poison, side effects and so on, restrict the development of the medicine to a certain degree. While the traditional Chinese medicine External Therapy is security, painless, convenient and inexpensive.It is easy to take and be accepted by patients, but also is an effective measures to promote the recovery of Stomach and Intestines Function. Therefore, it is necessary to discuss systematically the rule of Recovery of Gastrointestinal FuncTionl after cardiac surgery.And develop the optimization research in traditional Chinese medicine External Therapy.Objective To discuss systematically the Recovery of Gastrointestinal FuncTionl after cardiac surgery with the method of pressing ear acupoint. observeing the effect on accelerating recovery of gastrointestinal function, reducing abdominal distention,nausea and Vomitingby with the method, in order to form an idea in TCM of accelerating the postoperative recovery of gastrointestinal function and be widely promoted, to formulate an evaluation standards about postoperative gastrointestinal function.MethodAdopt prospective randomized study.60 patients of cardiac surgery were selected in the research during 2010-2011, and were divided into treatment group and control group with respective 30 cases according randomized control principle. To understand the law in recovery of gastrointestinal dysfunction complications by observing the anus-exhausting and bowel, abdominal distention, nausea and vomiting and so on during the control group, and analyze the relevant factors of pathogenesis. During the treatment group,from the first postoperative day, based on the conventional treatment, take a selection of lienal, stomach, duodenum small intestine, cardia and endocrine in the ears for the therapeutic point. Took a pill attached on the central of rubberized fabric sizeed 0.6cm×0.6cm, and then put it on the selected point with forceps. Daily press 3 to 5 times by itself or families, and press 30~ 60s on each point,3~7 replace 1 time, ears alternate. We study the effect of the method of pressing ear acupoint on accelerating recovery of gastrointestinal dysfunction complications after directvision operation Surgery of heart disease. Application software SPSS17.0 statistical analysis, with the treatment outcome using t-test and chi-square analysis.ResultThere were 18 cases of control group abdominal distension happened (60%), vomiting 13 cases (43%) while the treatment group abdominal distension occurred in 4 (13%), vomiting 0 case (0%), two groups of comparisons were statistically significant (P<0.05). In the control group the shortest recovery time for the bowel sounds was 18h, the longest was 52h, the mean was 42.73±16.32 h. The shortest was 22h in the first defecating time, the longest was 98h, average for 60.66±16.71h. While they were 33.76±6.55h and 47.63±10.40h respectively in the treatment group. Two groups of comparisons were statistically significant (p<0.05).The treatment group was higher than that the control group in test of MOT (P<0.05). The scores for the treatment group were all significantly higher than that of the control group about the gastrointestinal function after operation 1-7 days and it was statistically significant (p<0.05). The control group showed that patients with the more peri-operative bleeding and the longer the extracorporeal circulation time, aortic blocking time, anesthesia time, surgery time, the scores were higher during the period of postoperative observa-tion, and the incidence rate of postoperative complications of gastrointest-inal function was higher, the illness is more serious also.The age smaller or bigger the scoring was higher after operation, and it was more on gastrointest-inal functional influence.ConelusionBy the observation on the postoperative recovery of gastrointestinal function of the 30 patients in the control group combined with subjective indicators of observation and the test result of MOT, we can draw that patients adjust physiology function in self. During 48h postoperative, gastrointestinal function gradually improved, but the process slower. During 49h-120h postoper-ative, gastrointestinal function improved is quite obvious while the gastroin-testinal function continues to improve between 121h-168h and gradually tends to normal levels. Method of pressing ear acupoint can accelerate in postope-rative recovery of gastrointestinal function, ruduce abdominal distention, Nausea and Vomiting after direct vision operation of congenital heartdisease. And it is security, painless, convenient and inexpensive.It was easy to take and be accepted by patients, the effect is good,the maneuverability was strong. And it was facilitate in clinical application. |
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