急性脑卒中病人排便情况的影响因素分析
|
摘要
[目的]探讨急性脑卒中病人排便情况及其影响因素。[方法]选取陆军军医大学大坪医院神经内科住院的急性脑卒中病人200例,调查病人的一般资料、饮食、便秘情况、大便性状、美国国立卫生研究院卒中量表(NIHSS)评分和卒中危险因素,分析影响其排便的因素。[结果]急性脑卒中发病后首次排便便秘的发生率为36.5%,首次排便情况与诊断、NIHSS评分及进食方式有关(P<0.05)。病人后续排便的便秘发生率为39.5%、便秘后腹泻发生率为12.7%,后续排便情况与NIHSS评分、进食方式及干预方式有关(P<0.05)。[结论]神经功能受损情况是影响急性脑卒中病人排便的主要因素。对于卒中后便秘,药物干预总体效果差,便秘严重者采取口服缓泻剂与灌肠通便均不能缓解后续便秘状况,且增加了腹泻的风险。
Objective:To investigate the defecation situation and its influencing factors in patients with acute stroke.Methods:A total of200 patients with acute stroke,admitted to the department of neurology of Daping Hospital of Army Military Medical University,were selected to investigate the general data,diet,constipation,defecation,NIHSS score and risk factors of stroke,and the factors influencing their defecation were analyzed.Results:The incidence of first constipation after acute stroke was 36.5%.The first defecation was related to diagnosis,NIHSS score and feeding ways(P<0.05).The incidence of consequent constipation was 39.5%and the incidence of diarrhea was 12.7%.Consequent defecation was related to NIHSS score,feeding ways and the was of intervention(P<0.05).Conclusions:Impaired nerve function was the main factor affecting defecation in patients with acute stroke.For patients with poststroke constipation,the overall effect of drug intervention was poor.For those with severe constipation,taking oral laxative agent and enema for defecation could not relieve the subsequent constipation,and increase the risk of diarrhea.
Objective:To investigate the defecation situation and its influencing factors in patients with acute stroke.Methods:A total of200 patients with acute stroke,admitted to the department of neurology of Daping Hospital of Army Military Medical University,were selected to investigate the general data,diet,constipation,defecation,NIHSS score and risk factors of stroke,and the factors influencing their defecation were analyzed.Results:The incidence of first constipation after acute stroke was 36.5%.The first defecation was related to diagnosis,NIHSS score and feeding ways(P<0.05).The incidence of consequent constipation was 39.5%and the incidence of diarrhea was 12.7%.Consequent defecation was related to NIHSS score,feeding ways and the was of intervention(P<0.05).Conclusions:Impaired nerve function was the main factor affecting defecation in patients with acute stroke.For patients with poststroke constipation,the overall effect of drug intervention was poor.For those with severe constipation,taking oral laxative agent and enema for defecation could not relieve the subsequent constipation,and increase the risk of diarrhea.
引文
[1]Limi SF,Childs C.A systematic review of the effectiveness of bowel management strategies for constipation in adults with stroke[J].Int J Nurs Stud,2013,50(7):1004-1010.
[2]Lim YH,Kim DH,Lee MY,et al.Bowel dysfunction and colon transit time in brain-injured patients[J].Ann Rehabil Med,2012,36(3):371-378.
[3]Lim SF,Ong SY,Tan YL,et al.Incidence and predictors of newonset constipation during acute hospitalisation after stroke[J].Int J Clin Pract,2015,69(4):422-428.
[4]全国脑血管病会议.各类脑血管疾病诊断要点[J].临床荟萃,1988,29(8):367-368.
[5]Lewis SJ,Heaton KW.Stool Form Scale as a useful guide to intestinal transit time[J].Scand J Gastroenterol,1997,32(9):920-924.
[6]钟代曲,钱春荣.脑卒中三级预防护理手册[M].北京:北京师范大学出版社,2016:147-150.
[7]国家卫生计生委脑卒中筛查与防治工程委员会.脑卒中筛查与防治技术规范[J].中国医学前沿杂志,2013,5(9):44-50.
[8]付丽,陈长香.老年女性不同饮食及排便习惯与便秘发生的关系[J].护理学杂志,2010,25(7):42-43.
[9]陈建兵.对脑卒中后便秘与脑损伤的相关性研究[J].当代医药论丛,2014,12(20):196-197.
[10]Su Y,Zhang X,Zeng J,et al.New-onset constipation at acute stage after first stroke:incidence,risk factors,and impact on the stroke outcome[J].Stroke,2009,40(4):1304-1309.
[11]苏旭,赵晓荣,李淑杏,等.脑卒中后便秘患者不同护理干预方法的效果比较[J].中华现代护理杂志,2013,19(26):3207-3210.
[12]杨婕,黎恩知,杨蓉.脑卒中后大小便失禁发生率及危险因素的临床研究[J].护理研究,2013,27(4C):3928-3929.
[13]Robain G,Chennevelle JM,Petit F,et al.Incidence of constipation after recent vascular hemiplegia:aprospective cohort of 152patients[J].Rev Neurol(Paris),2002,158(5Pt1):589-592.
[14]薄希云.脑卒中患者便秘相关因素分析及护理干预进展[J].中国保健营养,2014,4:2379-2380.
[15]袁景,林桦,沈宏华.脑卒中后便秘治疗进展[J].中国实用神经疾病杂志,2016,19(11):96-98.
[16]高文勇,何萍.急性脑卒中患者腹泻并发症的临床分析[J].现代生物医学进展,2014,25(14):4921-4923.
[17]刘亚红.脑卒中患者便秘相关因素分析及护理干预进展[J].现代中西医结合杂志,2012,21(33):3758-3760.
[18]Sturtzel B,Mikulits C,Gisinger C,et al.Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors[J].J Nutr Health Aging,2009,13(2):136-139.
[19]郝贵枝,甘素梅.前瞻性护理干预对脑卒中偏瘫病人排便及相关并发症的影响[J].护理研究,2015,29(1A):98-99.
[20]林莹,梅嫦颖.脑卒中患者便秘原因分析与护理干预[J].现代实用医学,2015,27(10):1383-1384.
[21]钟代曲,钱春荣,沈盈盈.脑卒中三级预防健康教育方案的设计与应用[J].护理管理杂志,2016,16(10):755-757.
[22]Lim SF,Childs C.Constipation inpatients with stroke:incidence,associated risk factors and management at atertiary hospital in hospital[J].Int J Nurs Pract,2012,18(SI):9-10.
[23]李鑫,涂双燕,杨蓉.脑卒中患者便秘的护理新进展[J].华西医学,2015,30(11):2179-2181.
[24]Gallegos-Orozeo JF,Foxx-Orenstein AE,Sterler SM,et al.chronic constipation in the elderly[J].Am J Gastroenterol,2012,107(1):18-26.
[25]Corral JE,Kataria R,Vickers D,et al.Biofeedback therapy for chronic constipation in a patient with Prader-Willi syndrome[J].Ann Gastroenterol,2015,28(4):501-505.
[26]Li MK,Lee TFD,Suen KPL,et al.Complementary effects of auricular acupressure in relieving constipation symptoms and promoting disease specific health related quality of life:a randomized placebo-controlled trial[J].Complementary Therapies in Medicine,2014,22(2):266-277.
[2]Lim YH,Kim DH,Lee MY,et al.Bowel dysfunction and colon transit time in brain-injured patients[J].Ann Rehabil Med,2012,36(3):371-378.
[3]Lim SF,Ong SY,Tan YL,et al.Incidence and predictors of newonset constipation during acute hospitalisation after stroke[J].Int J Clin Pract,2015,69(4):422-428.
[4]全国脑血管病会议.各类脑血管疾病诊断要点[J].临床荟萃,1988,29(8):367-368.
[5]Lewis SJ,Heaton KW.Stool Form Scale as a useful guide to intestinal transit time[J].Scand J Gastroenterol,1997,32(9):920-924.
[6]钟代曲,钱春荣.脑卒中三级预防护理手册[M].北京:北京师范大学出版社,2016:147-150.
[7]国家卫生计生委脑卒中筛查与防治工程委员会.脑卒中筛查与防治技术规范[J].中国医学前沿杂志,2013,5(9):44-50.
[8]付丽,陈长香.老年女性不同饮食及排便习惯与便秘发生的关系[J].护理学杂志,2010,25(7):42-43.
[9]陈建兵.对脑卒中后便秘与脑损伤的相关性研究[J].当代医药论丛,2014,12(20):196-197.
[10]Su Y,Zhang X,Zeng J,et al.New-onset constipation at acute stage after first stroke:incidence,risk factors,and impact on the stroke outcome[J].Stroke,2009,40(4):1304-1309.
[11]苏旭,赵晓荣,李淑杏,等.脑卒中后便秘患者不同护理干预方法的效果比较[J].中华现代护理杂志,2013,19(26):3207-3210.
[12]杨婕,黎恩知,杨蓉.脑卒中后大小便失禁发生率及危险因素的临床研究[J].护理研究,2013,27(4C):3928-3929.
[13]Robain G,Chennevelle JM,Petit F,et al.Incidence of constipation after recent vascular hemiplegia:aprospective cohort of 152patients[J].Rev Neurol(Paris),2002,158(5Pt1):589-592.
[14]薄希云.脑卒中患者便秘相关因素分析及护理干预进展[J].中国保健营养,2014,4:2379-2380.
[15]袁景,林桦,沈宏华.脑卒中后便秘治疗进展[J].中国实用神经疾病杂志,2016,19(11):96-98.
[16]高文勇,何萍.急性脑卒中患者腹泻并发症的临床分析[J].现代生物医学进展,2014,25(14):4921-4923.
[17]刘亚红.脑卒中患者便秘相关因素分析及护理干预进展[J].现代中西医结合杂志,2012,21(33):3758-3760.
[18]Sturtzel B,Mikulits C,Gisinger C,et al.Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors[J].J Nutr Health Aging,2009,13(2):136-139.
[19]郝贵枝,甘素梅.前瞻性护理干预对脑卒中偏瘫病人排便及相关并发症的影响[J].护理研究,2015,29(1A):98-99.
[20]林莹,梅嫦颖.脑卒中患者便秘原因分析与护理干预[J].现代实用医学,2015,27(10):1383-1384.
[21]钟代曲,钱春荣,沈盈盈.脑卒中三级预防健康教育方案的设计与应用[J].护理管理杂志,2016,16(10):755-757.
[22]Lim SF,Childs C.Constipation inpatients with stroke:incidence,associated risk factors and management at atertiary hospital in hospital[J].Int J Nurs Pract,2012,18(SI):9-10.
[23]李鑫,涂双燕,杨蓉.脑卒中患者便秘的护理新进展[J].华西医学,2015,30(11):2179-2181.
[24]Gallegos-Orozeo JF,Foxx-Orenstein AE,Sterler SM,et al.chronic constipation in the elderly[J].Am J Gastroenterol,2012,107(1):18-26.
[25]Corral JE,Kataria R,Vickers D,et al.Biofeedback therapy for chronic constipation in a patient with Prader-Willi syndrome[J].Ann Gastroenterol,2015,28(4):501-505.
[26]Li MK,Lee TFD,Suen KPL,et al.Complementary effects of auricular acupressure in relieving constipation symptoms and promoting disease specific health related quality of life:a randomized placebo-controlled trial[J].Complementary Therapies in Medicine,2014,22(2):266-277.