振动疗法在神经外科重症病人便秘中应用的安全性与效果评价
摘要
[目的]将腹部振动疗法运用到神经外科重症便秘病人中,并探讨该疗法的安全性、可行性与效果。[方法]本研究为历史对照研究。对照组共21例,采用常规护理干预措施;干预组共19例,在常规护理干预措施的基础上结合腹部振动疗法。观察并记录干预组病人在T0(干预前5 min)、T_1(干预10 min时)、T_2(干预后5 min)、T_3(干预后60 min)的生命体征变化,干预组与对照组在24 h内的排便情况。[结果]两组病人基线资料比较差异无统计学意义(P>0.05);干预组病人在T_0、T_1、T_2、T_3时HR、SBP、MAP、SpO_2变化无统计学差异(P>0.05);干预组与对照组在24 h内的排便情况比较,差异有统计学意义(P<0.05),且干预组优于对照组。[结论]腹部振动疗法安全可行,可以改善病人便秘情况,或许能作为一种简单、经济、方便的非药物治疗辅助手段纳入到神经外科重症病人便秘管理中。
引文
[1] GUERRA T L D S,MENDON?A S S,MARSHALL N G.Incidence of constipation in an intensive care unit[J].Revista Brasileira de Terapia Intensiva,2013,25(2):87-92.
[2] 何静.神经外科重症颅脑损伤病人便秘因素的分析及相应护理措施的探讨[J].中国医药指南,2013(30):233-234.
[3] AZEVEDO R P D,MACHADO F R.Constipation in critically ill patients:much more than we imagine[J].Revista Brasileira de Terapia Intensiva,2013,25(2):73-74.
[4] WOLLERSHEIM T,HAAS K,WOLF S,et al.Whole-body vibration to prevent intensive care unit-acquired weakness:safety, feasibility, and metabolic response[J].Critical Care,2017,21(1):111.
[5] 崔龙.便秘治疗的再认识[J].临床外科杂志,2016(6):411-412.
[6] 魏俊吉,康德智,赵元立,等.神经外科重症管理专家共识(2013版)[J].中国脑血管病杂志,2013(8):436-448.
[7] FOUNDATION R.Guidelines-rome Ⅲ diagnostic criteria for functional gastrointestinal disorders[J].Journal of Gastrointestinal & Liver Diseases Jgld,2006,15(3):307-312.
[8] 张建宁.神经外科重症监护[M].北京:人民卫生出版社,2013:1.
[9] 颜玉贤,郑精选,蔡燕婷,等.腹部体外低频振动法在脑卒中便秘病人中的应用[J].护理实践与研究,2016,13(11):27-28.
[10] MCPEAKE J,GILMOUR H,MACINTOSH G.The implementation of a bowel management protocol in an adult intensive care unit[J].Nursing in Critical Care,2011,16(5):235-242.
[11] REINTAM B A,POEZE M,MALBRAIN M L,et al.Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome:a prospective multicentre study[J].Intensive Care Med,2013,39(5):899-909.
[12] GUERRA Tl M S M N.Incidência de constipa??o intestinal em uma unidade de terapia intensiva[J].Rev Bras Ter Intensiva,2013,25(2):87-92.
[13] VAN DER SPOEL J I,OUDEMANS-VAN S H,KUIPER M A,et al.Laxation of critically ill patients with lactulose or polyethylene glycol:a two-center randomized,double-blind, placebo-controlled trial[J].Crit Care Med,2007,35(12):2726-2731.
[14] 李宁.重视顽固性便秘规范化诊治[J].中国实用外科杂志, 2013(11):907-909.
[15] 张雪芳,徐桂华,李海,等.卧床病人功能性便秘的生物反馈治疗及有效护理探讨[J].西南军医,2010(1):151-152.
[16] TSUJIMURA A,YAMAMOTO Y,SAKODA S,et al.Finger taps and constipation are closely related to symptoms of overactive bladder in male patients with Parkinson′s disease[J].Int J Urol,2014,21(1):69-73.
[2] 何静.神经外科重症颅脑损伤病人便秘因素的分析及相应护理措施的探讨[J].中国医药指南,2013(30):233-234.
[3] AZEVEDO R P D,MACHADO F R.Constipation in critically ill patients:much more than we imagine[J].Revista Brasileira de Terapia Intensiva,2013,25(2):73-74.
[4] WOLLERSHEIM T,HAAS K,WOLF S,et al.Whole-body vibration to prevent intensive care unit-acquired weakness:safety, feasibility, and metabolic response[J].Critical Care,2017,21(1):111.
[5] 崔龙.便秘治疗的再认识[J].临床外科杂志,2016(6):411-412.
[6] 魏俊吉,康德智,赵元立,等.神经外科重症管理专家共识(2013版)[J].中国脑血管病杂志,2013(8):436-448.
[7] FOUNDATION R.Guidelines-rome Ⅲ diagnostic criteria for functional gastrointestinal disorders[J].Journal of Gastrointestinal & Liver Diseases Jgld,2006,15(3):307-312.
[8] 张建宁.神经外科重症监护[M].北京:人民卫生出版社,2013:1.
[9] 颜玉贤,郑精选,蔡燕婷,等.腹部体外低频振动法在脑卒中便秘病人中的应用[J].护理实践与研究,2016,13(11):27-28.
[10] MCPEAKE J,GILMOUR H,MACINTOSH G.The implementation of a bowel management protocol in an adult intensive care unit[J].Nursing in Critical Care,2011,16(5):235-242.
[11] REINTAM B A,POEZE M,MALBRAIN M L,et al.Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome:a prospective multicentre study[J].Intensive Care Med,2013,39(5):899-909.
[12] GUERRA Tl M S M N.Incidência de constipa??o intestinal em uma unidade de terapia intensiva[J].Rev Bras Ter Intensiva,2013,25(2):87-92.
[13] VAN DER SPOEL J I,OUDEMANS-VAN S H,KUIPER M A,et al.Laxation of critically ill patients with lactulose or polyethylene glycol:a two-center randomized,double-blind, placebo-controlled trial[J].Crit Care Med,2007,35(12):2726-2731.
[14] 李宁.重视顽固性便秘规范化诊治[J].中国实用外科杂志, 2013(11):907-909.
[15] 张雪芳,徐桂华,李海,等.卧床病人功能性便秘的生物反馈治疗及有效护理探讨[J].西南军医,2010(1):151-152.
[16] TSUJIMURA A,YAMAMOTO Y,SAKODA S,et al.Finger taps and constipation are closely related to symptoms of overactive bladder in male patients with Parkinson′s disease[J].Int J Urol,2014,21(1):69-73.