CAJ | 학술논문

目的：探讨耳穴埋籽对直肠癌M iles手术患者血流动力学及应激水平变化的影响研究。方法将92例直肠癌行M iles手术患者按照入院先后顺序随机分为观察组47例和对照组45例。对照组行常规围手术期护理，观察组在常规围手术期护理的同时给予耳穴埋籽，术后心电监护48 h ，24 h内每小时监测收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）、脉搏氧饱和度（SpO2），24 h后至48 h每2 h监测；在患者入院时、术后1 d、术后2 d监测血清皮质醇浓度。结果两组患者的收缩压、舒张压在12 h、18 h、24 h、36 h、48 h比较差异有统计学意义（P＜0．05），HR、RR、SpO2比较差异无统计学意义（P＞0．05），说明各组的 HR、RR、SpO2在各时间点虽有变化，但无显著影响；两组患者术前皮质醇浓度无明显差异，术后均明显升高，至术后第2天，观察组皮质醇浓度降至术前水平，对照组仍高于术前水平（P＜0．05）。结论耳穴埋籽在围手术期可以有效地稳定患者的SBP、DBP ；能够显著降低血清皮质醇的浓度，减轻机体应激反应。
목적：탐토이혈매자대직장암M iles수술환자혈류동역학급응격수평변화적영향연구。방법장92례직장암행M iles수술환자안조입원선후순서수궤분위관찰조47례화대조조45례。대조조행상규위수술기호리，관찰조재상규위수술기호리적동시급여이혈매자，술후심전감호48 h ，24 h내매소시감측수축압（SBP）、서장압（DBP）、심솔（HR）、호흡빈솔（RR）、맥박양포화도（SpO2），24 h후지48 h매2 h감측；재환자입원시、술후1 d、술후2 d감측혈청피질순농도。결과량조환자적수축압、서장압재12 h、18 h、24 h、36 h、48 h비교차이유통계학의의（P＜0．05），HR、RR、SpO2비교차이무통계학의의（P＞0．05），설명각조적 HR、RR、SpO2재각시간점수유변화，단무현저영향；량조환자술전피질순농도무명현차이，술후균명현승고，지술후제2천，관찰조피질순농도강지술전수평，대조조잉고우술전수평（P＜0．05）。결론이혈매자재위수술기가이유효지은정환자적SBP、DBP ；능구현저강저혈청피질순적농도，감경궤체응격반응。
Objective To study the effect on stress hormone level and hemo‐dynamics among colon cancer Miles patients treated by auricular seeds of traditional Chinese medicine .Method 92 patients with rectal cancer underwent Miles operation based on the order of admission were randomly divided into intervention group 47 cases and 45 cases of group control .The control group received routine nursing during operation period .The intervention groups re‐ceived auricular seeds in conventional operation period at the same time .Postoperative ECG monitoring was conduc‐ted for 48 h .The systolic and diastolic blood pressure ,heart rate ,respiratory rate ,pulse oxygen saturation was monitored each hours with 24 hours ,and monitored every 2 h after 24 h to 48 h .The serum cortisol concentration was monitored at the admission day ,1 days and two days after operation .Result The systolic blood pressure ,dias‐tolic blood pressure at 12 h ,18 h 24 h ,36 h and 48 h was significantly different between the two groups (P<0 .05) .There was no significant difference in RR ,HR ,SpO2 between the groups (P>0 .05) ,HR ,RR and SpO2 was changed in all groups at each monitor period .There was no significant difference between groups .The cortisol concentration was no significant difference between group before operation .Post‐operation cortisol were significant‐ly increased after second days ,and the intervention group decreased to preoperative levels .The cortisol concentration was higher than that of the preoperative level in control group (P<0 .05) .Conclusion Auricular seeds of TCM nurs‐ing during operation period can be effect for the stable of patients SBP and DBP ,and reduce remarkable the patients'serum concentration of cortisol and patients'stress reaction .