| Background:Gastrointestinal dysfunction is the most common complication after abdominal surgery,mainly manifested by abdominal distension,nausea,vomiting,anal stop exhaust and defecation.LaparoscoPic cholecystectomy(laparoscoPic cholecystectomy,LC)is one of the methods of abdominal surgery.Because of the influence of surgical trauma and general anesthesia of CO2,during operation,the following series of complications often occur,the main manifestation of which is gastrointestinal motility decline.Gastrointestinal peristalsis weakens or disappears,abdominal distension,abdominal pain,anus stop exhaust,defecation,etc.The above series of clinical symptoms are called postoperative gastrointestinal tract.Dysfunction.Once gastrointestinal dysfunction occurs after operation,it needs to be treated by fasting and non-drinking,gastrointestinal decompression,intravenous nutrition and so on,which often leads to nutritional dysfunction in patients’ nutritional intakes after operation.Severe complications such as increased intraperitoneal pressure,subsequent infection,non-healing wound,intestinal adhesion,intestinal obstruction,anastomotic fistula and other complications could aggravate the patient’s condition,prolong hospital stay,and increase the burden of medical treatment and the patient’s economic burden.Moxibustion can effectively treat postoperative gastrointestinal dysfunction,and the effect is obvious,the curative effect is exact,the cost is low,it is easy to be accepted by clinical practice.However,the time of moxibustion for the recovery of gastrointestinal function after abdominal surgery varies in clinical practice.It is reported in the literature that every 10～30min is different.The duration of moxibustion treatment is closely related to the curative effect,but there is no clinical study on the therapeutic effect of moxibustion duration on gastrointestinal dysfunction after abdominal surgery.Therefore,the aim of this study is to compare the effects of different moxibustion duration on gastrointestinal function after laparoscoPic cholecystectomy and the changes of comfort of patients,and to explore the optimal duration of moxibustion.In order to find the best curative effect-based moxibustion operation method,to provide the basis for clinical moxibustion operation.Objective:To verify the clinical effect of moxibustion on the recovery of gastrointestinal function after laparoscopic cholecystectomy and to explore the optimal duration of moxibustion to promote the recovery of gastrointestinal function after laparoscopic cholecystectomy.Through the study of the optimal duration of moxibustion to improve the pertinence and effective rate of clinical nursing work.Promote the formation of standardization of traditional Chinese medicine nursing technology,promote the continuous develoPment of traditional Chinese medicine nursing technology.Methods:From October,2017 to APril,2018,84 patients with general general anesthesia and laparoscopic cholecystectomy in general general anesthesia were randomly divided into 4 groups.The control group received general anesthesia after laparoscopic cholecystectomy for 10 min,moxibustion for 20 min,and moxibustion for 30 min.On the basis of the control group,the control group was treated with moxibustion for the first time at 6 hours after the operation and the patient was given bilateral treatment at 10:00 a.m.and 16:00 p.m.on the first day of the operation.Zusanli point moxibustion was treated to 3 days after operation or for the first time,and the duration of each time was 10 min,20 min and 30 min respectively.The time for recovery of bowel sounds after the operation of each group was recorded;for the first time,the first time of defecation;the time to withstand the solid food;the time of hospital stay;the total cost of hospitalization;the first day,the second day,the third day of the abdominal pain score(Visual Analogue Score,VAS)after the operation;and when the patient was admitted,One week post-operative gastrointestinal symptom score(GIS)The score,the gastrointestinal symptom rating scale(GSRS)score,the Kolkaba’s comfort state scale(GCQ)score and the anxiety self-rating scale(SAS)score,the pre-discharge satisfaction,and the adverse reaction during the post-hospital stay.Results:(1)General data of the four groups:age,sex,height,weight,anesthetic use,operation time,anaesthesia time,intraoperative blood loss,intraoperative urine volume,American College of anesthesiologists(American Society of Anesthesiologists,ASA).There was no significant difference between the two groups(P>0.05).There were no significant differences in GSRS score,GCQ score,GIS score and SAS score between the four groups at admission,which proved that the baseline of the four groups was consistent and comparable.(2)Compared with the control group,the recovery time of intestinal sound,the first exhaust time and the first defecation time in the moxibustion 30min group and the moxibustion 20min group were significantly shorter than those in the control group(P<0.01 or P<0.05).The days of hospitalization and the total cost of hospitalization were significantly decreased(P<0.01orP<0.05),and the scores of VAS abdominal pain were significantly decreased on the first day and the second day after operation(P<0.01or P<0.05),and the scores of abdominal pain on the first day and the second day after operation were significantly lower than those on the second day(P<0.05).One week after operation,GSRS score decreased significantly,GCQ score increased significantly,the difference was statistically significant(P<0.05).Compared with the control group,there was significant difference in the time of tolerating solid food for the first time in moxibustion 30min group(P<0.05),and the satisfaction score before discharge was higher than that in control group(P<0.05).There was no significant difference in GIS score and SAS score between the four groups one week after operation and one week after operation(P>0.05).Compared with the control grou,there were no significant changes in the first exhaust time,the first defecation time,the first tolerance to solid food,the postoperative analgesia,the postoperative hospitalization days,and the total cost of hospitalization in the moxibustion 10min group.There was no significant difference between the two groups.(3)Compared with the control group,there were no significant changes in the first exhaust time,the first defecation time,the first tolerant solid food time,postoperative analgesia,postoperative hospitalization days and total hospitalization expenses in the moxibustion 10min group.There was no significant difference(P>0.05).(4)Compared with moxibustion group in 30 min group and moxibustion 20min group,the total hospitalization cost was significantly reduced,and other indexes had no obvious advantage,and there was no statistical difference(P>0.05).(5)Compared with moxibustion 10min group,the recovery time of intestinal sound,the time of first exhaust,the time of first defecation,the time of first tolerant solid food,the days of hospitalization and the total cost of hospitalization in moxibustion 30min group were significantly lower than those in moxibustion 10min group.The difference was statistically significant(P<0.01).(6)Compared with moxibustion 10min group,the recovery time of intestinal sound,the time of first exhaust,the time of first defecation,the days of hospitalization and the total cost of hospitalization in moxibustion 20min group were significantly lower than those in moxibustion 10min group(P<0.05).(7)There were no adverse reactions in each group.Conclusions:(1)Moxibustion for 20 min and 30 min can improve the gastrointestinal dysfunction after laparoscoPic cholecystectomy,shorten the recovery time of intestinal sound,the first exhaust time and the first defecation time after laparoscopic cholecystectomy,and can effectively relieve the postoperative pain.Improve the gastrointestinal function after operation,increase the comfort of the patients;Moxibustion for 30 min can shorten the time of the patient to endure solid food for the first time,obviously reduce the total cost of hospitalization,and save the medical cost,which is worthy of clinical popularization or further study.(2)Moxibustion 10min had no significant effect on gastrointestinal dysfunction after laparoscopic cholecystectomy.The first time of exhaust,the time of first defecation,the time of first tolerance to solid food,the postoperative analgesia and the days of hospitalization after operation were not significantly improved in patients undergoing laparoscopic cholecystectomy.There were no significant changes in hospital exenses and other aspects,and there was no significant difference between the two groups. |
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