CAJ | 학술논문

目的：观察皮硝外敷对老年腹部手术患者术后早期炎性肠梗阻的作用。方法将35例术后早期炎性肠梗阻患者随机分为观察组19例和对照组16例，除观察组加用皮硝外敷外，2组患者的治疗方法相同。分别观察2组患者治疗前后腹胀消失时间、肛门排气时间、血清肌酸磷酸激酶水平、血清C反应蛋白水平、血清IL-6水平和TNF-α水平等的变化，同时，观察两组患者治疗前后的感染发生率和术后住院时间。结果与对照组比较，观察组患者术后腹痛、腹胀均明显缓解（P＜0.05），肛门排气时间缩短（P＜0.05）。观察组术后5d血清CPK值水平较对照组明显降低（P＜0.05），术后3d 、7d血清CRP水平也分别降于对照组（P＜0.05），并且，其血清IL-6、TNF-α水平下降速度也明显快于对照组（P＜0.05）；术后感染发生率较对照组明显降低（P＜0.05），术后住院时间明显缩短（P＜0.05）。结论采用皮硝外敷可有效地缓解老年术后早期炎性肠梗阻患者的临床症状，促进肠功能恢复和改善患者临床转归。
목적：관찰피초외부대노년복부수술환자술후조기염성장경조적작용。방법장35례술후조기염성장경조환자수궤분위관찰조19례화대조조16례，제관찰조가용피초외부외，2조환자적치료방법상동。분별관찰2조환자치료전후복창소실시간、항문배기시간、혈청기산린산격매수평、혈청C반응단백수평、혈청IL-6수평화TNF-α수평등적변화，동시，관찰량조환자치료전후적감염발생솔화술후주원시간。결과여대조조비교，관찰조환자술후복통、복창균명현완해（P＜0.05），항문배기시간축단（P＜0.05）。관찰조술후5d혈청CPK치수평교대조조명현강저（P＜0.05），술후3d 、7d혈청CRP수평야분별강우대조조（P＜0.05），병차，기혈청IL-6、TNF-α수평하강속도야명현쾌우대조조（P＜0.05）；술후감염발생솔교대조조명현강저（P＜0.05），술후주원시간명현축단（P＜0.05）。결론채용피초외부가유효지완해노년술후조기염성장경조환자적림상증상，촉진장공능회복화개선환자림상전귀。
Objective To investigate the effect of Natrii sulfas external applying for aged patients with early postoperative In-flammatory small bowel obstruction (EPISBO) after abdominal surgery. Methods Thirty-five cases of aged patients with EPISBO were randomly divided into treatment group (n=19) and control groups(n=16),and the same treatment was given in two groups ex-cept that the treatment group were applied externally with Natrii sulfas. The disappearing time of abdominal distention ,the time of anus exhaust,the levels of serum creatine phosphokinase (CPK),the levels of serum C-reactive protein (CRP),the levels of serum IL-6,the levels of serum TNF-alphe,the incidence of postoperative infection and the time of hospital stay of the patients with EPISBO in two groups before and after treatment were observed and compared respectively. Results Compared with the control group,the clinical symptoms such as abdominal pain and distention in the treatment group were significantly eased (P<0.05),the time of anus exhaust was shortened (P<0.05). the levels of CPK in the treatment group after surgery 5d was lower than the control group,and the levels of CRP and serum IL-6,TNF-α of the treatment groups after surgery 3d,7d were lower than the control group respectively (P<0.05),and the incidence of postoperative infection was decreased significantly (P<0.05),and the time of hospital stay was shorten (P<0.05). Conclusion Natrii sulfas external applying can effectively eased the clinical symptoms of the aged patients with EPISBO,promote the recovery of intestinal function and improve the clinical outcome.