| Objective:To investigate the status of the recovery of gastrointestinal function in patients with primary hepatocellular carcinoma(HHC)with liver cirrhosis after partial hepatectomy,and to explore the effectiveness of Tsusanli acupoint application combined with auricular acupoint pressing after partial hepatectomy to promote the recovery of gastrointestinal function.MethodsThe first stage:The method of convenient sampling was used to choose the hospital in the Department of hepatobiliary surgery,the First Affiliated Hospital of Guangxi Medical University from September 2016 to February 2017,to open the abdominal cavity with general anesthesia and to perform partial hepatectomy,and to investigate the postoperative patients with HCC combined with cirrhosis.Including the patient’s bowel sound recovery time,the first anus exhaust,the time of defecation,the patient’s first feeding time,the adverse reaction after eating,according to the Kendall sample size estimation method,the sample amount is 10~20 times as much as the observation variable,and the estimated estimated amount is 60-120.In this subject,a total of 98 patients who were hospitalized and operated on were collected.For the research object,collect observation indexes,calculate the average value of the measured data,calculate the incidence of counting data,and provide baseline data for the next stage of intervention research.The second stage:In the Department of hepatobiliary surgery,the First Affiliated Hospital of Guangxi Medical University from March 2017 to September 2017,the First Affiliated Hospital of Guangxi Medical University was hospitalized in the Department of hepatobiliary surgery.According to the first stage of the study,the average time of anal exhaust after first operation was61.65+21.94h,and 63 cases in each group.The total sample size was 189.This study was a randomized controlled study.The patients were divided into 3groups randomly.The control group was used in the routine treatment of Department of hepatobiliary surgery and the standard of ward nursing.On the basis of the control group,the experimental group I used Tsusanli acupoint application combined with auricular acupoint press on the basis of the control group.The experimental group II used Bilateral Tsusanli point injection of vitamin B1 on the basis of the control group.Collection of postoperative data from 3 groups of patients,the recovery time of bowel sounds,the first anus exhaust,the time of defecation and postoperative abdominal distention score,the difference of abdominal circumference before and after the operation,the first feeding time after the operation,the adverse reaction after eating,and the postoperative hospitalization time were evaluated.All data were statistically analyzed by SPSS17.0 statistical software,3 groups of measurement data were analyzed by single factor analysis of variance,LSD analysis,and counting data were checked with chi square test,and postoperative hospitalization time analyzed by Kruskal-Wallis H test.Result(1)58.2%of the patients recovered(~—x=26.78+13.1h)in 24h after operation;45.9%of the patients had first anal exhaust(~—x=61.87+21.94h)in48-72h time after operation;79.6%of the patients had the first anal defecation(x~—=101.65+37.07h)after 72h;(2)41.8%of the patients began to eat in 24-48h after operation,and the first meal was flat.The average time was x~—=55.35+20.61h,and the incidence of nausea and vomiting after the first meal was 22.4%.(3)49%of the patients were discharged from 5-10d after operation,and the average time of hospitalization was x~—=11.96+5.83d.(4)compress group,acupuncture group and control group’s bowel sound recovery time were 23.38+5.25,23.01+6.81h,26.21+8.83,the first anus exhaust time was 56.29+15.02,56.65+19.69h,63.90+19.54,and the first defecation time was 95.85+31.60,96.68+37.24h,111.79+37.15h:experimental group I and acupuncture group bowel singing The time of sound recovery,the first anus exhaust and defecation time were earlier than the control group,the difference was statistically significant(P<0.05).There was no significant difference between the experimental group I and the experimental group II bowel sound recovery time,the difference of the first anus exhaust and the time of defecation(P>0.05).(5)Compress group and acupuncture group patients with abdominal distention second days after operation The degree score was lower than the control group,the difference was statistically significant(P<0.05).There was no significant difference between the compress group and the acupuncture group patients’abdominal distention grade second days after operation(P>0.05).There was no significant difference between the 3 groups after the first day of operation(P>0.05).Compress group and acupuncture group patients Shu Houdi The difference between abdominal circumference and preoperative abdominal circumference of two days was less than that of the control group,the difference was statistically significant(P<0.05).The difference between abdominal circumference and preoperative abdominal circumference of the compress group and the acupuncture group patients second days after operation was not statistically significant(P>0.05).The difference between the abdominal circumference and preoperative abdominal circumference of the 3 groups was not statistically significant.Meaning(P>0.05).(6)the average time for the first feeding of the experimental group I and the experimental group was 40.5219.17h,and the 42.51+21.44h was lower than the first feeding time of 57.45+21.19h,and the difference was statistically significant(P<0.05).The incidence of nausea and vomiting after the first feeding of the test group was 8.1%.The incidence of nausea and vomiting after the first feeding of the test group was11..3%,the incidence of nausea and vomiting was 21.7%in the lower control group,and there was a significant difference in the incidence of adverse reactions after feeding in the 3 groups(P<0.05).(7)the average time of hospitalization was 11.04±5.34 days in the experimental group I and the experimental group,and the 10.29±5.59 days was 11.17±5.26 days after the operation,and the difference was not statistically significant(P>0.05).Conclusion1.After partial hepatectomy in HCC patients with liver cirrhosis,the time of gastrointestinal function recovery and the first feeding time after the operation were basically the same,but the recovery was delayed than that of the abdominal operation.2.Tsusanli acupoint compress combined with auricular acupoint press and Tsusanli point injection can promote the recovery of gastrointestinal function after the operation,and there is no significant difference in the effect of the two.The acupoint application of Tsusanli and the acupoint pressing of the Tsusanli is a noninvasive operation,and it has a wider application prospect.3.Tsusanli acupoint application combined with auricular pressing can shorten the fasting time after HCC and reduce the adverse reactions,which is worthy of clinical application... |
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