ABSTRACT
ObjectiveTo observe the effect of early-stage intervention with acupuncture on gastrointestinal dysfunction in critically ill patients.MethodTotally 112 critically ill patients were randomized into two groups. Based on the treatment for primary disease, the conventional group additionally received Lived Combined B. Subtilis and E. Faecium Enteric-coated Capsules, plus Alanyl Glutamine injection when parenteral alimentation was required; in addition to the treatments given to the conventional group, the acupuncture group received electroacupuncture, once a day. Before treatment, and on treatment day 7 and day14, the gastrointestinal function and nutritional state (hemoglobin, albumin), nutrition type, APACHEⅡscore, incidence rate of gastrointestinal function failure, and mortality rate were evaluated and compared.ResultAfter 7-day treatment, the gastrointestinal function scores were significantly improved in both groups (P0.05), and the difference was insignificant between the two groups (P>0.05); after 14-day treatment, the hemoglobin levels were significantly changed in both groups compared to that before treatment (P0.05), and the between-group difference was statistically insignificant (P>0.05); after 14-day treatment, the albumin levels were significantly changed in both groups compared to that before treatment (P0.05), though the death rate was comparatively lower in the acupuncture group; in the acupuncture group, 3 patients turned from complete parenteral nutrition to mixed nutrition, while 4 patients turned to mixednutrition because of intolerance to enteral nutrition and 2 cases turned to complete parenteral nutrition in the conventional group.Conclusion The two groups of treatments both can effectively improve the gastrointestinal function, decrease the incidence rate of gastrointestinal function failure, and the efficacy in the acupuncture group was more significant than that in the conventional group;the two groups of treatments both can sustain the gastrointestinal function and nutrition supply, and improve the nutrition state of the patients, and the acupuncture group was superior to the conventional group; the two methods both can effectively reduce APACHEⅡ score and improve the prognosis, while the acupuncture group was superior to the conventional group. Regardingthe death rate and enteral nutrition, the acupuncture group produced a higher comprehensive efficacy than the conventional group.
ABSTRACT
PURPOSE: The use of a total gastrectomy for gastric cancer has increased with the increasing incidence of gastric cancer involving the proximal stomach. Various types of reconstruction have been introduced to reduce the associated complications, such as reflux esophagitis and malnutrition, following a total gastrectomy. METHODS: Between January 2002 and September 2003, the incidence of reflux esophagitis and the nutritional status, according to three types of reconstructive, were analyzed in 67 patients who underwent a total gastrectomy for gastric cancer involving the proximal stomach. The three types of reconstruction were a Lygidakis pouch (LY-26 cases), a Hunt-Laurence pouch (HR-25 cases) and an Aboral pouch (AB-16 cases). RESULTS: Twenty three (88%), 21 (84%) and 10 (62%) patients complained of reflux esophagitis symptoms following the Lygidakis pouch, Hunt-Laurence pouch and Aboral pouch procedures, respectively. Less reflux esophagitis complications were observed following the Aboral pouch than with the other two procedures (P=0.03). No significant differences were found in the levels of serum hemoglobin, cholesterol, total protein and albumin for nutritional status between the three types. CONCLUSIONS: The Aboral pouch procedure was superior to the other two reconstructive procedures with respect to reflux esophagitis.