早期肠内营养联合穴位按摩在先天性心脏病术后患儿胃肠功能恢复的效果研究

Effect of Early Enteral Nutrition Combined with Acupoint Massage on Gastrointestinal Function Recovery in Children after Congenital Heart Disease Surgery

摘要: 目的：探讨早期肠内营养联合穴位按摩对先天性心脏病(CHD)术后患儿胃肠功能恢复的干预效果。方法：选取2024年1月至2025年12月在广西中医药大学附属瑞康医院胸心血管外科行体外循环CHD手术的120例患儿为研究对象，采用随机数字表法分为对照组(A组)、早期肠内营养组(B组)、穴位按摩组(C组)及联合组(D组)，每组各30例。A组给予CHD术后常规护理，B组在常规护理基础上实施早期肠内营养干预，C组在常规护理基础上实施穴位按摩干预，D组在常规护理基础上实施早期肠内营养联合穴位按摩干预。比较四组患儿术后首次排便时间、肠鸣音恢复时间，干预7天内胃肠道功能紊乱(恶心呕吐、腹胀、腹泻)发生率以及术后住院时长。结果：1) 胃肠功能恢复指标：D组术后首次排便时间、肠鸣音恢复时间均显著短于A组、B组、C组(P < 0.05)；B组、C组上述指标均短于A组(P < 0.05)，B组与C组在术后首次排便时间比较上差异有统计学意义(P < 0.05)，且C组术后首次排便时间短于B组，但C组与B组在肠鸣音恢复上差异无统计学意义(P > 0.05)。2) 胃肠道功能紊乱发生率：D组胃肠道功能紊乱总发生率(3.33%)显著低于A组(40.00%)、B组(16.67%)、C组(16.67%) (P < 0.05)；B组、C组均低于A组(P < 0.05)。3) 术后住院时长：D组术后住院时长短于A组、B组、C组(P < 0.05)，B组、C组上述指标均短于A组(P < 0.05)，但B组与C组之间术后住院时长差异无统计学意义(P> 0.05)。结论：早期肠内营养联合穴位按摩可有效缩短CHD术后患儿首次排便时间与肠鸣音恢复时间，降低胃肠道功能紊乱发生率，缩短术后住院时长，且效果优于单一早期肠内营养或穴位按摩干预，是CHD术后患儿胃肠功能恢复的有效干预方案。

Abstract: Objective: This paper aims to explore the effect of early enteral nutrition combined with acupoint massage on gastrointestinal function recovery in children after congenital heart disease (CHD) surgery. Methods: A total of 120 children undergoing CHD surgery with cardiopulmonary bypass were enrolled from the Thoracic and Cardiovascular Surgery Department of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine between January 2024 and December 2025. They were randomly assigned via random number table into four groups (30 cases each): control group (Group A), early enteral nutrition group (Group B), acupoint massage group (Group C), and combined intervention group (Group D). Group A received routine postoperative care; Groups B and C were given early enteral nutrition and acupoint massage respectively on the basis of routine care; Group D adopted combined early enteral nutrition and acupoint massage. Postoperative first defecation time, bowel sound recovery time, 7-day incidence of gastrointestinal dysfunction (nausea and vomiting, abdominal distension, diarrhea), and postoperative hospital stay were compared among the four groups. Result: 1) Gastrointestinal function indexes: Group D had significantly shorter first defecation time and bowel sound recovery time than Groups A, B and C (P < 0.05). These indexes in Groups B and C were superior to Group A (P < 0.05). Group C showed earlier first defecation than Group B (P < 0.05), while no significant difference was found in bowel sound recovery time between Groups B and C (P > 0.05). 2) Gastrointestinal dysfunction incidence: The total incidence in Group D was 3.33%, obviously lower than 40.00% in Group A, 16.67% in Group B and 16.67% in Group C (P < 0.05); Groups B and C also had lower incidence than Group A (P < 0.05). 3) Postoperative hospital stay: Group D had the shortest hospital stay compared with the other three groups (P < 0.05). Groups B and C had shorter hospital stays than Group A (P<0.05), with no significant difference between Groups B and C (P > 0.05). Conclusion: Early enteral nutrition combined with acupoint massage can effectively shorten first defecation time and bowel sound recovery time, reduce the incidence of gastrointestinal dysfunction, and cut down postoperative hospital stay in children after CHD surgery. Its efficacy is superior to single intervention alone, which can serve as an optimal measure to promote gastrointestinal function recovery in postoperative CHD children.