Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Heling ¹ ,  JIANG Yanhua ¹ , WU Chuanmei ¹ , CHEN Yanli ¹ , TANG Qiuyue ¹ , LUO Shan ¹ , WANG Yaqin ¹ , LIAO Jia ¹ , WEI Xing ¹ , DAI Zhen ² , DAI Wei ¹ , SHI Qiuling ³

1. Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;
2. Chengdu Center for Disease Control and Prevention, Chengdu, 610041, P. R. China;
3. Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;

Corresponding?author：

JIANG Yanhua, Email: 1544693323@qq.com

Keywords：

Lung cancer; postoperative constipation; influencing factor; morphine

DOI：

10.7507/1007-4848.202109021

Video：

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Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

Citation： ZHOU Heling, JIANG Yanhua, WU Chuanmei, CHEN Yanli, TANG Qiuyue, LUO Shan, WANG Yaqin, LIAO Jia, WEI Xing, DAI Zhen, DAI Wei, SHI Qiuling. Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(10): 1402-1406. doi: 10.7507/1007-4848.202109021 Copy

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2.	中國醫師協會腫瘤醫師分會, 中國醫療保健國際交流促進會腫瘤內科分會. Ⅳ期原發性肺癌中國治療指南(2021年版). 中華腫瘤雜志, 2021, 43(1): 39-59.
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4.	李丹鳳, 張蘭, 張宏敏. 復方丁香開胃貼聯合中藥穴位貼敷治療肺癌患者術后便秘療效研究. 陜西中醫, 2018, 39(10): 1375-1377.
5.	王豫鮮, 孔紅武, 杜晶晶, 等. 腹部推拿聯合穴位貼敷治療老年患者肺癌術后便秘的效果觀察. 中國現代醫生, 2020, 58(28): 166-169.
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8.	張遠強, 魏星, 謝少華, 等. 肺切除患者術后住院期間阿片類藥物應用情況及其影響因素的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2022, 29(7): 909-913.
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10.	張立力, 臧瑜. MD安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.
11.	李春蕊, 張雯, 樊碧發. 數字評分法(NRS)與口述評分法(VRS)在老年慢性疼痛患者中的比較. 中國疼痛醫學雜志, 2016, 22(9): 683-686.
12.	Swarm RA, Paice JA, Anghelescu DL, et al. Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2019, 17(8): 977-1007.
13.	呂恒剛, 宋云平, 郭莘. 便秘的危害及預防. 解放軍預防醫學雜志, 2019, 37(8): 198.
14.	彭彬, 李國鋒. 便通膠囊防治胸腔鏡術后便秘的隨機對照研究. 世界中醫藥, 2020, 15(18): 2772-2775, 2780.
15.	楊梅, 周倩. 甲狀腺疾病病人術后便秘現狀及其影響因素. 護理研究, 2018, 32(23): 3733-3737.
16.	胡燕, 陸晶晶, 葉藝, 等. 胃癌患者術后早期下床活動的最佳證據應用. 上海護理, 2021, 21(5): 22-26.
17.	周曉琪, 顏巧元, 譚翠蓮. 胃腸道惡性腫瘤患者術后便秘的原因及治療護理進展. 現代臨床護理, 2017, 16(6): 76-81.
18.	高寅麗, 李利亞, 李佩文. 癌癥患者便秘原因分析與治療進展. 中國中醫急癥, 2009, 18(1): 115-117.
19.	彭燕, 宋金春, 李榮凌, 等. 2009—2010年我院術后鎮痛藥應用分析. 中國醫院用藥評價與分析, 2012, 12(1): 48-50.
20.	姚真, 徐曉婉, 劉敏, 等. 癌痛患者阿片類藥源性便秘護理干預進展. 護士進修雜志, 2017, 32(6): 508-510.
21.	Wall T, Sherwin A, Ma D, et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br J Anaesth, 2019, 123(2): 135-150.
22.	吳鴿, 林沈嫻, 朱奇, 等. 阿片類藥物是否窮途末路? 中國疼痛醫學雜志, 2021, 27(3): 212-215.
23.	王穩, 孫莉. 阿片類藥物相關性便秘的研究進展. 中國疼痛醫學雜志, 2016, 22(5): 378-382.
24.	趙炳媛, 劉鳳, 姜桂春, 等. 腫瘤患者阿片類藥物相關性便秘嚴重程度現狀及影響因素分析. 護理學報, 2019, 26(11): 9-14.
25.	Imai H, Fumita S, Harada T, et al. Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): A post hoc subgroup analysis of patients with lung cancer. Jpn J Clin Oncol, 2021, 51(3): 444-450.
26.	Farmer AD, Holt CB, Downes TJ, et al. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol, 2018, 3(3): 203-212.
27.	許陶. 腫瘤患者阿片類藥物所致便秘嚴重程度調查及相關因素分析. 護理實踐與研究, 2020, 17(21): 32-34.
28.	楊梅, 牛玲莉, 鄭娥, 等. 基于加速康復外科理念肺癌患者出院準備度與出院指導質量現狀及相關性分析. 中國胸心血管外科臨床雜志, 2019, 26(9): 905-909.

1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
2. 中國醫師協會腫瘤醫師分會, 中國醫療保健國際交流促進會腫瘤內科分會. Ⅳ期原發性肺癌中國治療指南(2021年版). 中華腫瘤雜志, 2021, 43(1): 39-59.
3. 鄭中龍, 李濤, 卿松. 全程管理體系在肺癌患者術后便秘的預防及治療中的應用. 黑龍江醫學, 2020, 44(8): 1013-1015.
4. 李丹鳳, 張蘭, 張宏敏. 復方丁香開胃貼聯合中藥穴位貼敷治療肺癌患者術后便秘療效研究. 陜西中醫, 2018, 39(10): 1375-1377.
5. 王豫鮮, 孔紅武, 杜晶晶, 等. 腹部推拿聯合穴位貼敷治療老年患者肺癌術后便秘的效果觀察. 中國現代醫生, 2020, 58(28): 166-169.
6. 陳群英, 肖娟. 胸腰椎骨折術后患者發生便秘的影響因素分析. 解放軍護理雜志, 2014, 31(9): 43-46.
7. Dai W, Xie S, Zhang R, et al. Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: A multicentre, prospective, observational cohort study protocol. BMJ Open, 2019, 9(10): e030726.
8. 張遠強, 魏星, 謝少華, 等. 肺切除患者術后住院期間阿片類藥物應用情況及其影響因素的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2022, 29(7): 909-913.
9. Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: The validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
10. 張立力, 臧瑜. MD安德森癥狀評估量表肺癌模塊的修訂和考評. 腫瘤, 2013, 33(5): 434-438.
11. 李春蕊, 張雯, 樊碧發. 數字評分法(NRS)與口述評分法(VRS)在老年慢性疼痛患者中的比較. 中國疼痛醫學雜志, 2016, 22(9): 683-686.
12. Swarm RA, Paice JA, Anghelescu DL, et al. Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2019, 17(8): 977-1007.
13. 呂恒剛, 宋云平, 郭莘. 便秘的危害及預防. 解放軍預防醫學雜志, 2019, 37(8): 198.
14. 彭彬, 李國鋒. 便通膠囊防治胸腔鏡術后便秘的隨機對照研究. 世界中醫藥, 2020, 15(18): 2772-2775, 2780.
15. 楊梅, 周倩. 甲狀腺疾病病人術后便秘現狀及其影響因素. 護理研究, 2018, 32(23): 3733-3737.
16. 胡燕, 陸晶晶, 葉藝, 等. 胃癌患者術后早期下床活動的最佳證據應用. 上海護理, 2021, 21(5): 22-26.
17. 周曉琪, 顏巧元, 譚翠蓮. 胃腸道惡性腫瘤患者術后便秘的原因及治療護理進展. 現代臨床護理, 2017, 16(6): 76-81.
18. 高寅麗, 李利亞, 李佩文. 癌癥患者便秘原因分析與治療進展. 中國中醫急癥, 2009, 18(1): 115-117.
19. 彭燕, 宋金春, 李榮凌, 等. 2009—2010年我院術后鎮痛藥應用分析. 中國醫院用藥評價與分析, 2012, 12(1): 48-50.
20. 姚真, 徐曉婉, 劉敏, 等. 癌痛患者阿片類藥源性便秘護理干預進展. 護士進修雜志, 2017, 32(6): 508-510.
21. Wall T, Sherwin A, Ma D, et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br J Anaesth, 2019, 123(2): 135-150.
22. 吳鴿, 林沈嫻, 朱奇, 等. 阿片類藥物是否窮途末路? 中國疼痛醫學雜志, 2021, 27(3): 212-215.
23. 王穩, 孫莉. 阿片類藥物相關性便秘的研究進展. 中國疼痛醫學雜志, 2016, 22(5): 378-382.
24. 趙炳媛, 劉鳳, 姜桂春, 等. 腫瘤患者阿片類藥物相關性便秘嚴重程度現狀及影響因素分析. 護理學報, 2019, 26(11): 9-14.
25. Imai H, Fumita S, Harada T, et al. Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): A post hoc subgroup analysis of patients with lung cancer. Jpn J Clin Oncol, 2021, 51(3): 444-450.
26. Farmer AD, Holt CB, Downes TJ, et al. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol, 2018, 3(3): 203-212.
27. 許陶. 腫瘤患者阿片類藥物所致便秘嚴重程度調查及相關因素分析. 護理實踐與研究, 2020, 17(21): 32-34.
28. 楊梅, 牛玲莉, 鄭娥, 等. 基于加速康復外科理念肺癌患者出院準備度與出院指導質量現狀及相關性分析. 中國胸心血管外科臨床雜志, 2019, 26(9): 905-909.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization

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