黄道琼 陈瑜 李海燕 郑梦静 孙彩霞 贺彩芳

[摘要] 目的 探讨耳穴压豆在肝癌肝动脉化疗栓塞术后便秘患者中的应用。 方法 选取2018年6月～2019年5月我科拟行经肝动脉化疗栓塞的原发性肝癌患者，随机分为试验组和对照组，每组各40例;两组患者均给予常規治疗护理方案，试验组在对照组基础上于患者行动脉化疗栓塞术后当日给予耳穴压豆，观察两组患者术后肛门首次排便时间及第0、2、4、6天患者便秘症状评分。 结果 试验组及对照组肝动脉化疗栓塞术后肛门首次排便时间分别为（29.83±4.01）h、（48.23±7.11）h（t=-8.151，P=0.000），两组差异有统计学意义（P<0.05），试验组便秘症状评分显著优于对照组（P<0.05）。 结论 耳穴压豆可以有效预防肝动脉化疗栓塞术后便秘的发生，值得临床推广。

[关键词] 肝癌;肝动脉化疗栓塞;便秘;耳穴压豆

[中图分类号] R473          [文献标识码] B          [文章编号] 1673-9701（2020）35-0179-04

[Abstract] Objective To explore the application of ear point pressing bean in patients with constipation after hepatic artery chemoembolization for liver cancer. Methods From June 2018 to May 2019， patients with primary liver cancer who were scheduled to undergo transhepatic artery chemoembolization in our department were randomly divided into the experimental group and the control group， with 40 cases in each group. Both groups were given conventional treatment and nursing programs. The patients in the experimental group were also given ear point pressing bean on the day after the arterial chemoembolization. The time of the first defecation and the constipation symptom score of the two groups on the 0th， 2， 4， and 6 days was observed. Results The first defecation time in the experimental group and the control group after hepatic artery chemoembolization was（29.83±4.01）h， and（48.23±7.11）h （t=-8.151， P=0.000）， and the difference between the two groups was statistically significant（P<0.05）. The constipation symptom score of the experimental group was significantly better than that of the control group（P<0.05）. Conclusion Ear point pressing bean can effectively prevent the occurrence of constipation after hepatic artery chemoembolization and is worthy of clinical promotion.

[Key words] Liver cancer; Hepatic artery chemoembolization; Constipation; Ear point pressing bean

经肝动脉化疗栓塞术（Transcatheter Arterial Che-moembolization，TACE）[1]成为肝癌非手术治疗中使用最安全有效的方法，被公认为是不能进行手术切除肝癌患者的首选治疗方法[2]。多数患者TACE术后会出现发热、恶心、呕吐、腹胀、腹痛、食欲不振、大便困难等情况，影响患者对TACE治疗的评价[3]。其中便秘是TACE术后最为常见的并发症之一，发生率高达47.3%[4]，便秘使肠道中废物、毒物不能及时排出体外，导致血氨增高;用力排便是引起上消化道大出血的一大诱因，严重影响患者的生活质量。目前临床多用各种缓泻剂、饮食调节、灌肠等方法预防和缓解TACE术后患者的便秘，但大多难收到持久疗效，长期应用易形成药物依赖和相应副作用的产生。为降低TACE术后患者便秘的发生率，我科采用中医耳穴压豆的方法，研究其对TACE术后患者排便的影响。……