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针灸促进腹腔镜下直肠癌腹会阴联合切除术后排尿功能恢复的临床研究
The Clinical Research on the Recovery of Urinary Function after Laparoxcopic Miles’ Operation Thougth Using Acupuncture and Moxibustion
【作者】 严银波;
【导师】 樊志敏;
【作者基本信息】 南京中医药大学 , 中医学, 2011, 硕士
【摘要】 [目的]研究针灸对腹腔镜下直肠癌腹会阴联合切除术后排尿功能恢复的影响。证明这种干预措施能促进直肠癌术后排尿功能恢复且是一种相对安全、疗效显著的方法。[方法]本试验为前瞻性随机对照研究,将2010年6月至2011年03月间入住南京市中医院且行腹腔镜下直肠癌腹会阴联合切除术的符合纳入标准的患者30例,随机分入试验组15例和对照组15例。试验组及对照组均予术前宣教、术后夹闭尿管训练等留置导尿标准护理,试验组的患者术后第三日起予针灸治疗,每日一次,连续针灸治疗至术后第七日。对照组不予任何处理。观察两组在术后7日拔出尿管后膀胱残余尿、排尿功能等级、排尿积分、是否发生尿潴留、是否需要再次留置尿管等情况。两组间计量资料用均数±标准差描述,采用t检验,两组间计数资料比较采用卡方检验和秩和检验。检验水准取0.05,所有数据用SPSS17.0软件进行统计学分析。[结果]两组患者年龄、性别构成、Dukes分期、手术时间均有可比性,在排尿积分、膀胱残余尿、术后排尿功能等级上试验组优于对照组(P<0.05),而拔管后尿潴留发生率及再次留置尿管的发生率两组未有明显差异(P>0.05)。[结论]针灸能够较好地改善腹腔镜下直肠癌腹会阴联合切除术后患者的排尿情况,提高患者的生活质量,但本试验中未能降低其拔管后尿潴留的发生率。
【Abstract】 [Objective] To observe the recovery of the urinary function after Laparoscopic Miles’ operation by using acupuncture and moxibustion.And to extrapolate the effect that the acupuncture and moxibustion have obvious curative effects for the urinary function recovery.[Method] This is a prospective randomized controlled study.30 patients suffered from rectal cancer who stay at Nanjing Chinese Medicine Hospital for Miles’operation between june 2010 and march 2011 were randomly divided into experimental group 15 cases and control group 15 cases. Both groups were treated with standard care about indwelling urinal catheter.Else,the experimental group patients were also treated with the acupuncture and moxibustion therapeutics.The treatment were taken from the third day after the operation,qd, until the seventh day.Pull out the catheter and to observe the residual urine volume in the bladder,the rank of cystic function,the grade of cystic function and have uroschesis or not.Measurement data between the two groups were described with a mean±standard deviation,and were compared by t test.Count data between the two groups were compared with chi-square test and rank test.Test level is 0.05, all data used SPSS 17.0 for statistical analysis.[Results] The patients’age,sex,Dukes stages,operation time are comparable(P>0.05).There were significant difference in the residual urine volume in the bladder,the rank of cystic function and the grade of cystic function(P<0.05). There were not significant difference (P>0.05) between the groups on the incidence of uroschesis.[Conclusion] Using the acupuncture and moxibustion can accelerate the urinary function recovery after Laparoscopic Miles’ operation.And can to improve the quality of life of Patients. But can not avoid the happen of the uroschesis after pull out the catheter.
【Key words】 rectal carcinoma; urinary dysfunction; acupuncture and moxibustion; uroschesis;