Objective: To observe the clinical effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis(SAP) complicated with paralytic ileus. Methods: A total of 60 SAP patients complicated with paralytic ileus treated in the First People's Hospital of Huzhou from June 2015 to June 2017 were selected and randomly divided into two groups by random lottery method, with 30 cases in each group.The two groups were treated with routine anti-infection and rehydration.The control group was treated with traditional Chinese medicine enema combined with placebo, and the observation group was treated with traditional Chinese medicine enema combined with rhubarb on Shenque acupoint, and the two groups were treated for 7d.The recovery time of blood amylase, bowel sounds recovery time, first self defecation time, local complications and mortality were observed in the two groups. Results: The recovery time of blood amylase, the recovery time of intestinal sound and the time of the first defecation were (8.87±2.30)d, (2.88±1.09)d and (3.51±1.32)d, respectively, which were significantly shorter than those of the control group [(10.29±2.01)d, (3.67±1.30)d and (4.57±1.41)d], the differences were statistically significant(t=-3.601, -3.607, -4.251, all P<0.001). The incidence rate of local complications in the observation group was 6.7%(2/30), which was significantly lower than 36.7%(11/30) in the control group(χ²=16.875, P<0.001), and there was no statistically significant difference in the mortality rate between the two groups(χ²=3.333, P=0.068). Conclusion The application of Chinese medicine enema combined with the acupoint of rhubarb in the treatment of SAP patients complicated with paralytic ileus can effectively promote the recovery of intestinal peristalsis, shorten the duration of paralytic intestinal obstruction, reduce the complications and improve the clinical effect.

Objective To analyze the related risk factors of functional intestinal obstruction in general surgical patients and to discuss the feasible nursing and prevention measures. Methods The clinical data of totally 658 patients after abdominal surgery who received open abdominal surgery in the Department of General Surgery of the First People's Hospital of Huzhou in Zhejiang Province from January 2015 to January 2017 were retrospectively analyzed. These patients were divided into the intestinal obstruction group and the non-intestinal obstruction group based on the occurrence of postoperative functional intestinal obstruction. The single factor analysis was then conducted over the age, gender, operation time, anesthesia, postoperative analgesic use (opioids and non-opioids), abdominal operation history, smoking history, alcohol drinking history, diabetes mellitus history and history of hypertension; and Logistic regression analysis was also performed on the influencing factors to determine the impact of functional intestinal obstruction in patients who received open abdominal surgery. Results Totally 47 out of the 658 patients receiving open abdominal surgery developed functional intestinal obstruction, with an incidence of 7.14%. The univariate analysis showed that there were statistically significant differences between the two groups in gender, age, operation time, postoperative analgesic use, history of abdominal surgery and history of diabetes mellitus (P<0.05). According to the multivariate Logistic regression analysis, gender, age, operation time, history of abdominal surgery and history of diabetes were the risk factors of postoperative functional intestinal obstruction (P<0.01). Conclusions The relevant risk factors for postoperative functional intestinal obstruction in general surgical patients after abdominal surgery include gender, age, operation time, history of abdominal surgery and diabetes mellitus. Corresponding nursing and prevention measures should be taken according to the relevant risk factors of patients.