Liu Yunhong, Chan Carmen W H, Chow Ka Ming, Zhang Binbin, Zhang Xue, Wang Chao, Du Guangzhong
Nursing Department, Qilu Hospital of Shandong University, Jinan, China.
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Asia Pac J Oncol Nurs. 2023 Apr 10;10(5):100229. doi: 10.1016/j.apjon.2023.100229. eCollection 2023 May.
Postoperative gastrointestinal dysfunction occurred up to 25% of patients who undergo colorectal cancer surgery, which could cause severe complications and increase economic burden. This study aims to evaluate the effectiveness of nurse-delivered acupressure on early postoperative gastrointestinal function among patients undergoing colorectal cancer surgery.
A total of 112 adult patients (≥ 18 years) scheduled to receive colorectal cancer surgery were randomized into two groups. Acupressure was practiced at ST36 for five days after operation, while the control group used gently rubbing skin. Primary outcomes were the time to first passage of flatus and defecation, while the secondary outcomes were the degree of abdominal distention and bowel motility. The Student's -test and Mann-Whitney test or Chi-square test and regression analyses were used, while for repeated measures of outcomes, area under the curve (AUC) was compared between groups and subgroups.
After adjusting for potential confounding variables, acupressure significantly shortened the time to have first flatus passage by 11.08 h (95%CI: -19.36 to -2.81; < 0.01). The first passage time of defecation (mean, 77.00 ± 36.27 h vs. 80.08 ± 28.88 h), abdominal distention (AUC, 5.68 ± 5.24 vs. 5.92 ± 4.03), and bowel motility (AUC, 12.09 ± 4.70 vs. 11.51 ± 3.00) in the intervention group had some improvement although the differences were not statistically significant ( > 0.05).
This study indicated that acupressure done by trained nurses could be an effective and feasible solution to promote early gastrointestinal function recovery among patients undergoing colorectal cancer surgery.
Chinese Clinical Trial Registry (ChiCTR-IOR-17012460).
高达25%的接受结直肠癌手术的患者会出现术后胃肠功能障碍,这可能导致严重并发症并增加经济负担。本研究旨在评估由护士实施的穴位按压对结直肠癌手术患者术后早期胃肠功能的有效性。
共有112例计划接受结直肠癌手术的成年患者(≥18岁)被随机分为两组。术后在足三里穴进行穴位按压,持续5天,而对照组采用轻轻摩擦皮肤的方法。主要结局指标为首次排气和排便时间,次要结局指标为腹胀程度和肠道蠕动情况。采用t检验、Mann-Whitney检验或卡方检验及回归分析,对于结局指标的重复测量,比较组间及亚组间的曲线下面积(AUC)。
在调整潜在混杂变量后,穴位按压显著缩短了首次排气时间11.08小时(95%CI:-19.36至-2.81;P<0.01)。干预组的首次排便时间(平均,77.00±36.27小时 vs. 80.08±28.88小时)、腹胀(AUC,5.68±5.24 vs. 5.92±4.03)和肠道蠕动(AUC,12.09±4.70 vs. 11.51±3.00)虽有改善,但差异无统计学意义(P>0.05)。
本研究表明,由经过培训的护士进行穴位按压可能是促进结直肠癌手术患者早期胃肠功能恢复的一种有效且可行的方法。
中国临床试验注册中心(ChiCTR-IOR-17012460)