小承气合剂促进结肠吻合术后胃肠动力恢复的临床观察(1)
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[摘要] 目的：观察小承气合剂早期应用对结肠吻合术后胃肠动力恢复的临床护理观察。方法：对结肠吻合术后106例患者，用随机法分为实验组和对照组，实验组于术后4 h开始鼻饲小承气合剂，对照组组自术后保持禁食至肛门排气；记录肠鸣音的恢复、第1次排气、第1次排便时间。结果：实验组与对照组患者，平均肠鸣音恢复时间分别为术后(11.67±1.77) h、(18.39±3.21) h；平均首次排气时间分别为(19.00±2.76) h、(28.09±5.14) h；平均首次排便时间分别为(29.04±10.37) h、(42.27±7.13) h。结论：术后早期应用小承气合剂对促进结肠吻合术后胃肠动力的恢复是有效的、安全可行的。
[关键词] 小承气合剂；结肠吻合术；胃肠功能恢复
[中图分类号] R289 [文献标识码]B[文章编号]1673-7211(2008)11(b)-045-02
The clinical observation on the promotion of Xiaochengqi mixture to the recovery of gastrointestinal motility after the colonic anastomosis
YANG Li-ming, ZHANG Fang-ping, QIN You, CHEN Si-wei
(Department of Bone Surgery, Fangcun Branch of Guangdong Hospital of TCM, Guangzhou 510120, China)
[Abstract] Objective: To observe the influence of stomach intestine functional recovery by drenching xiaochengqi mixture in all earlier period of posteolocolic anastomosis. Methods: A total of 106 patients selected from the postcolocolic anastomosis were randomly divided into groupⅠandⅡ，groupⅠwas treated with xiaochengqi mixture 4 hours after surgery and groupⅡwas treated with nothing，and we observed the recovery time of bowel sounds，the time of first air bleed，and the time of first defecation. Results: The average time of the first of bowel sound was (11.67±1.77) h in group I，and (18.39±3.21) h in group Ⅱ. The average time of the first air bleed was (19.00±2.76) h in group Ⅰ，and (28.09±5.14) h in group Ⅱ. The average first defecation time was (29.04±10.37) h，(42.27±7.13) h. Conclusion: Xiaochengqi mixture can promote the stomach intestine functional recovery，in an earlier period of postcolocolic anastomosis，and reduce the occurrence of short-term complication significantly，and have important effect in preventing the long-term postoperative entero-complications.
[Key words] Xiaochengqi mixture; Postcolocolic anastomosis; Stomach intestine functional recovery
腹部手术可引起胃肠功能紊乱，出现暂时性肠麻痹，肠道功能抑制时间越长，肠道液体及积气越多，从而出现肠管扩张和腹胀，不利于机体的恢复，甚至引起肠粘连梗阻、吻合口瘘等严重并发症。因此，术后胃肠功能的早期恢复对术后患者的整体恢复及防止术后并发症均有重要意义。小承气合剂是在小承气汤的基础上加味丹参，组方为：大黄(后下)6 g，厚朴10 g，枳实10 g，丹参30 g，加水500 ml，煎至150 ml。小承气合剂不但保留了小承气汤原有的促胃肠动力作用 ......
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