Effect Of Zusanli Injection Of Neostigmine On The Recovery Of Gastrointestinal Function After Hepatobiliary Surgery

Objective: To explore the effect of neostigmine on the recovery of gastrointestinal function after hepatobiliary surgery.Methods:From April to November 2018,50 eligible patients with flatulence due to limited recovery of gastrointestinal function after hepatobiliary surgery in the second hospital of Hebei Medical University were randomly divided into two groups: control group and observation group,with the principle of random distribution;the control group usually adopts general postoperative routine care(i-level care),and is given according to the physical condition of patients The patients were treated with liver protecting drugs(glutathione,magnesium isoglycate,etc.),acid inhibiting drugs(proton pump inhibitors),antibiotics to prevent infection(cephalosporins),rehydration and bromhexin expectoration.At the same time,according to the anesthesiologist's instructions,the patients' head horizontal position was reduced,the cerebral blood flow was speeded up,and the patients were in a supine position for 6-8 hours.At the same time,they were fasted and forbidden to drink,and the upper cardiac electric blood pressure and oxygen were measured Saturation monitoring,(if there is a drainage tube)ask the family members to observe the patient's drainage tube intermittently,timely report the flow,color and nature of the drainage tube,and timely record.When the patient's condition allows,the class can be resumed,the general condition is good,and the vital signs are stable.You can seek doctors or nurses to help the patient get out of bed in time.In the observation group,in addition to the above-mentioned general nursing and treatment measures,after the patient's condition was stable for 2 hours,the Zusanli acupoints(both sides)were located by the method of body surface positioning.After the precise positioning was completed and the patient was informed,1 ml of neostigmine was injected into the acupoints by syringe.After the operation,the first time of intestinal peristalsis,recovery time of bowel sound and first time of exhaust were observed and recorded,At the same time,the change degree of abdominal circumference and the occurrence of abdominal pain and distention were measured;the data collected from the monitoring were input into the statistical software,and the data were analyzed and counted by spss21.0 statistical software,including t-test,x2 test and Wilcoxon rank sum test.Results : 1.There was no significant difference in age and gender between the two groups(P > 0.05).Similarly,there was no significant difference in operation time,operation mode,anesthesia time and previous medical history(P > 0.05).2.The recovery time of the patients in the observation group was(13.87 ± 2.73)hours,that in the control group was(18.23 ± 3.14)hours,that in the observation group was(16.02 ± 3.07)hours,and that in the control group was(21.94 ± 3.68)hours.After Wilcoxon rank sum test,there was a significant difference in the composition of the first exhaust time between the two groups(w = 426.500,P < 0.05);3.The abdominal distention of the observation group was mainly grade 0 and grade I,accounting for 92.0%(23 / 25);the control group was mainly grade I or grade II,accounting for 76.0%(19 / 25);the difference between the two groups was statistically significant(w = 414.500,P < 0.05).Conclusions:1.After hepatobiliary surgery,a large proportion of patients will have clinical symptoms such as limited recovery of gastrointestinal function caused by operation time,anesthesia mode,anesthetic effect,operation itself and incision stimulation,etc.,especially abdominal pain and abdominal distention caused by exhaust failure.2.If the patient's body condition is good after operation,neostigmine can be injected into Zusanli acupoint on both legs.This method can effectively accelerate the recovery of gastrointestinal function,make the frequency of bowel sound return to normal as soon as possible,shorten the first exhaust time,prevent and reduce the incidence of abdominal distention,and further prevent a series of clinical complications caused by long-term bed rest.3.The advantage of this method is that it can make neostigmine reach the acupoint point of stomach meridian of Foot Yangming quickly by bypassing the natural barrier of human skin.The drug directly acts on stomach meridian of Foot Yangming which is closely related to gastrointestinal function,and the effect of the drug is more rapid and direct.4.This method is easy to operate,safe and noninvasive,and has good acceptance ability and compliance.A large number of clinical data show that this method has satisfactory and good clinical effect and high clinical practice value.