穴位按摩护理改善胸腰椎骨折术后腹胀、便秘的疗效观察

钟文+黄慧芬++孙巧玉

[摘要] 目的 探討穴位按摩护理对胸腰椎骨折术后患者腹胀、便秘的效果。 方法 选择2015年10月～2016年10月广州中医药大学第三附属医院骨科收治的50例胸腰椎骨折患者作为研究对象，按随机数字表法分成对照组和观察组，每组各25例。对照组采用胸腰椎骨折术后常规护理，观察组在对照组的基础上采用穴位按摩手法——腹部穴位（中脘、天枢、气海）按摩护理1周。比较两组患者术后首次肛门排气时间、腹胀改善时间、首次排便时间和1周内排便次数，以评价两组患者的临床效果。 结果 观察组患者术后首次肛门排气时间、腹胀改善时间和首次排便时间均明显较对照组短，差异有统计学意义（P < 0.05）；观察组在1周内排便次数明显较对照组多，差异有统计学意义（P < 0.05）；观察组治疗总有效率高于对照组，差异有统计学意义（P < 0.05）。 结论 穴位按摩手法护理可明显改善胸腰椎骨折术后患者腹胀、便秘的症状，对胸腰椎术后患者腹胀便秘的治疗有积极的指导意义。

[关键词] 胸腰椎骨折；术后；穴位按摩；护理

[中图分类号] R47 [文献标识码] A [文章编号] 1673-7210（2017）06（b）-0174-04

Observation of curative effect of acupoint massage therapy on bloating and constipation in patients with thoracolumbar fractures

ZHONG Wen HUANG Huifen SUN Qiaoyu

Department of Orthopedics， the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine，Guangdong Province， Guangzhou 510375， China

[Abstract] Objective To explore the effect of acupoint massage therapy on bloating and constipation in patients with thoracolumbar fractures. Methods Fifty patients with thoracolumbar fractures treated by the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from October 2015 to October 2016 were selected as the subjects， and they were divided into control group and observation group according to random number table， with 25 patients in each group. The patients in the control group were treated with routine nursing after horacolumbar fractures surgery. The patients in the observation group were treated with routine nursing plus acupoint massage-abdominal acupoints （Zhongwan， Tianshu， Qihai） massage for 1 week. First anal exhaust time， bloating improvement time， first defecation time and the defecation frequency in one week of the patients after the operation in the two groups were compared， in order to evaluate the clinical effect. Results The first anal exhaust time， bloating improvement time， first defecation time in the observation group were shorter than those in the control group， with statistically significant difference （P < 0.05）. The defecation frequency in one week in the observation group was significantly higher than that in the control group， with statistically significant difference （P < 0.05）. The total effective rate of the observation group was higher than that of the control group， with statistically significant difference （P < 0.05）. Conclusion Acupoint massage therapy can significantly improve the symp toms of bloating and constipation in patients with thoracolumbar fractures. It has a positive guiding significance for the treatment of bloating constipation in patients with thoracolumbar surgery.

[Key words] Thoracic and lumbar fractures； Postoperative； Acupuncture point massage； Nursing

胸腰椎骨折是脊柱骨科常见病，胸腰椎骨折后，由于患者椎体及周边附件受伤出血，引起腹膜后血肿，加之术中创伤出血，影响腹腔神经功能，导致肠麻痹，胃肠蠕动减慢，出现腹部胀满，甚至发生便秘[1]；中医认为胸腰椎术后腹胀、便秘属于脾胃病系的“腹胀”“便秘”范畴，证属气滞血瘀型。胸腰椎骨折或手术的创伤，导致机体肝胃气滞而使机体气机升降失常，浊气上逆导致腹胀，腑气不通则便秘。腹胀便秘是胸腰椎骨折后较为多见的并发症，其发生率能达到40.5%～88.2%[2]。穴位按摩护理是通过刺激患者腹部特定的穴位，疏通经络，通调脏腑，以达到通腑排便，缓解腹胀便秘。因此，术后早期对腹部进行穴位按摩护理干预，能显著促进肠蠕动恢复，并有效预防腹胀发生。……