加速康复外科理念下中西医结合治疗对阑尾炎患者术后炎症反应及疼痛程度的作用
Intervention Effect of Integrated Traditional Chinese and Western Medi-cine Therapy on Postoperative Inflammation and Pain Degree of Patients with Appendicitis Under the Concept of Accelerated Rehabilitation Surgery
莫毓 1尹林 1蔡尚坤 1李海寿 1褚立岩 1韦合雷1
作者信息
- 1. 547000 广西壮族自治区 河池,河池市人民医院胃肠外科
- 折叠
摘要
目的 探究加速康复外科(ERAS)理念下中西医结合治疗对阑尾炎患者术后炎症反应及疼痛程度的作用.方法 选取2021 年6 月—2023 年1 月接受腹腔镜阑尾切除术治疗的阑尾炎 98 例,根据治疗方法不同将其分为观察组(50 例)和对照组(48 例)2 组.观察组采取ERAS理念下中西医结合治疗,对照组采取常规西医治疗.比较2组手术相关指标、肠道屏障功能、炎性指标及术后疼痛程度、睡眠质量、并发症情况.结果 观察组首次排气时间、肠鸣音恢复时间、首次排便时间、术后首次下地活动时间和住院时间均短于对照组(P＜0.01).术后1、2 和3d,观察组D-乳酸、二胺氧化酶、内毒素、可溶性细胞间黏附分子-1、C反应蛋白、白细胞及静息时和活动时疼痛数字评估法评分低于对照组,理查兹-坎贝尔睡眠量表各维度评分高于对照组(P＜0.05,P＜0.01).术后,观察组并发症发生率4.00%(2/50)与对照组并发症发生率12.50%(6/48)比较差异无统计学意义(P＞0.05).结论 ERAS理念下中西医结合治疗阑尾炎术后患者可减轻炎症反应,缓解疼痛,改善睡眠质量,加速胃肠功能恢复,促进早期康复.
Abstract
Objective To explore the role of integrated traditional Chinese and Western medicine therapy in postoper-ative inflammatory reaction and pain degree in patients with appendicitis under the concept of accelerated rehabilitation surgery(ERAS).Methods In total,98 patients with appendicitis who received laparoscopic appendectomy from June 2021 to Janu-ary 2023 were selected and divided into two groups according to different treatment methods:observation group(n =50)and control group(n =48).The observation group was treated with integrated traditional Chinese and Western medicine under the concept of ERAS,while the control group was treated with conventional Western medicine.The operative indexes,intestinal barrier function,inflammatory indexes,postoperative pain,sleep quality and complications were compared between the two groups.Results Time to the first anal exhaust,bowel sound recovery time,time to the first defecation time,time to the first postoperative off-bed activity and length of hospitalization in observation group were shorter than those in control group(P＜0.01).At 1,2 and 3 days after surgery,the scores of D-lactic acid(D-LA),diamine oxidase(DAO),endotoxin,soluble intercellular adhesion molecule-1(sICAM-1),C-reactive protein(CRP),white blood cells(WBC),numeric pain rating scale score at resting and active state were lower in the observation group than in the control group,and the scores of Richards-Campbell sleep scale were higher than those in the control group(P＜0.05,P＜0.01).After surgery,there was no signifi-cant difference in the complication rate between the observation group and the control group[4.00%(2/50)vs.12.50% (6/48)] (P ＞0. 05). Conclusion The integrated traditional Chinese and Western medicine in the treatment of postopera-tive appendicitis under the concept of ERAS can alleviate inflammatory reaction, relieve pain, improve sleep quality, acceler-ate gastrointestinal function recovery and promote early recovery.
关键词
加速康复外科理念/中西医结合疗法/阑尾炎/D-乳酸/二胺氧化酶/可溶性细胞间黏附分子-1/C反应蛋白/疼痛Key words
Concept of accelerated rehabilitation surgery/Integrated Traditional Chinese and Western medicine ther-apy/Appendicitis/D-lactate/Diamine oxidase/Soluble intercellular adhesion molecule-1/C-reactive protein/Pain引用本文复制引用
基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210957)
广西壮族自治区河池市科学技术局项目(2021AB41881)
出版年
2023
国家科技期刊平台
NSTL
万方数据