大承气颗粒剂在腹腔镜全子宫切除术围手术期的应用

作者	单位
曹保利	天津市南开医院
焦丽	天津市南开医院
刘笑梅	天津市南开医院
张乃岩	天津市南开医院
毛雪梅	天津市南开医院

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中文摘要:

目的观察大承气颗粒剂对妇科腹腔镜全子宫切除术围手术期应用的效果。方法选择腹腔镜微创全子宫切除手术患者201例,随机分为治疗组和对照组。治疗组103例,术前1天下午4时口服大承气颗粒剂9 g(3袋),术后16 h口服大承气颗粒剂6 g(2袋);对照组98例,术前1天晚8时肥皂水400 mL灌肠1次,术后16 h新斯的明1 mL足三里穴位注射。结果201例腹腔镜全子宫切除术均在镜下顺利完成,无中转开腹,无手术并发症发生。治疗组手术时间平均(116.8±29.7)min,术中出血量平均(141.6±25.1)mL,术后体温平均(37.38±1.39)℃;对照组手术时间平均(119.6±28.4)min,术中出血量平均(150.2±22.1)mL,术后体温平均(37.55±0.43)℃,各指标比较,差异无统计学意义(P>0.05)。术后第1天白细胞计数:治疗组平均(11.18±2.93)×109/L,对照组平均(12.57±3.55)×109/L,差异有统计学意义(P<0.01);术后排气时间:治疗组平均(35.66±5.72)h,对照组平均(41.77±6.06)h,差异有统计学意义(P<0.01);术后排便时间治疗组平均(48.47±18.97)h,对照组平均(54.81±21.30)h,差异有统计学意义(P<0.05)。结论术前及术后早期使用大承气颗粒剂,不仅优于术前灌肠,保证妇科手术顺利进行,而且明显促进术后早期胃肠功能恢复,提高围手术期治疗效果。

英文摘要:

Objective To observe the effects of Dachengqi Granule(DCG) in the recovery of gastrointestinal function and the condition of patients in the perioperative period of total laparoscopic hysterectomy.Methods Two hundred and one patients received total laparoscopic hysterectomy were assigned to 2 groups,the treated group(103 cases) was orally administered DCG twice,9 g at 4∶00 pm,one day before operation and 6 g at 16 h after operation,while to the control group,enema with 400 mL of soap solution at 8∶00 pm one day before operation and acupoint ST 36 injection with 1 mL neostigmine at 16 h after operation were given.Results Total laparoscopic hysterectomy was accomplished successfully in all patients,no need to receive open abdominal operation,and with no post-operational complications.In the treated group,the operation time was(116.8±29.7) min,the operative blood loss was(141.6±25.1) mL,the post-operative temperature was(37.38±1.39)℃,while those in the control group were(119.6±28.4) min,(150.6±22.1) mL,and(37.55±0.43) ℃,correspondingly,showing insignificant difference between the two groups(P>0.05).The white blood cell count on the 1st day after operation was(11.18±2.93)×109/L in the treated group,and(12.57±3.55)×109/L in the control group(P<0.01);time for post-operative aerofluxus in them was(35.66±5.72) h,and(41.77±6.06) h;time for post-operative defecation(48.47±18.97) h,and(54.81±21.30) h,respectively,all showed statistical difference between the two groups(P<0.01 or P<0.05).Conclusion Administering DCG before and early after operation can effect better than pre-operational enema in ensuring the gynecological operation progression smoothly,and it could also promote the recovery of post-operational gastrointestinal function and improve patients′ condition in the perioperative period.

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