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The influencing factors of constipation after stroke: a meta-analysis

ObjectiveTo systematically evaluate the related factors of constipation in patients with stroke. MethodsCochrane Library, PubMed, Web of Science, Embase, CNKI, VIP, Wanfang and China Biomedical Literature Database were searched by computer, and the retrieval time was set to May 2022. Case-control studies, cohort studies and cross-sectional studies on stroke and constipation were selected. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 13 studies involving 2 834 patients were included. Meta-analysis showed that age [odds ratio (OR) =2.54, 95% confidence interval (CI) (1.36, 3.73), P<0.001], lesion location [OR=1.98, 95%CI (1.27, 3.11), P=0.003], National Institutes of HealthStroke Scale score [OR=0.40, 95%CI (0.10, 0.70), P=0.010], hemiplegia [OR=4.31, 95%CI (2.59, 7.17), P<0.001], dysphagia [OR=2.32, 95%CI (1.27, 4.25), P=0.006], antidepressants [OR=2.33, 95%CI (1.62, 3.34), P<0.001], BI score [OR=?17.08, 95%CI (?33.07, ?1.08), P=0.04], eating pattern [OR=4.18, 95%CI (1.16, 15.09), P=0.030], drinking water volume ≥800 mL [OR=0.30, 95%CI (0.19, 0.46), P<0.001] might be the influencing factors of constipation in patients after stroke. The results of sensitivity analysis showed that age, education level, diabetes, smoking, stroke type, lesion location, diuretic and BI score might be the influencing factors of constipation after stroke (P<0.05). The results of bias analysis suggest that publication bias is less likely. Conclusions There are many risk factors for constipation in patients with stroke. Current evidence shows that age, diabetes, smoking and other 11 factors may be risk factors for stroke constipation, while high education level and drinking water ≥800 mL may be protective factors, and the other influencing factors have not been determined and need further study.

老年患者便秘的臨床護理

【摘要】 目的 總結老年患者便秘的臨床護理方法。 方法 將2007年5月-2009年5月收治的70歲以上老年患者62例隨機分為對照組30例和觀察組32例，所有患者按臨床常規護理、調節飲食、增加活動量、腹部按摩，在此基礎上對照組口服溫脾湯，觀察組采用便秘灸穴位敷貼，觀察兩組排便情況及不適癥狀。 結果 觀察組不適癥狀明顯少于對照組，兩組治療效果。 結論 便秘灸治療老年患者便秘痛苦小、副作用少、使用方便，近期效果滿意。

乙狀結腸造瘺術后腸瘺手術的護理體會一例

Some Questions about the Diagnosis and Treatment of Chronic NonSpecific Constipation

1概述便秘是很常見的癥狀，在美國便秘的發生率為2%，英國為10%，日本為4%，我國天津為4.4%［1］，女性發病概率是男性的3倍。多數便秘患者可經藥物治療治愈或改善癥狀，少數為難治性。少數便秘患者經手術治療效果較好。便秘不是一種病，而是多種疾病的一個癥狀，不同的患者有不同的含義，包括： ①大便量少、硬，排出困難； ②排便困難合并一些特殊的癥候群，如長期用力排便、直腸脹感、排便不完全或依靠手法幫助排便； ③7天內排便次數少于2～3次。臨床上常診斷為慢性頑固性便秘或特發性便秘，但其確切含義很難描述。“慢性”意指病史至少2年，或年幼時就發病； “特發性”說明我們對便秘的原因及流行病學了解不全面； “頑固性”意指經一般藥物及非手術治療很難奏效，常需手術治療［2］。

Analysis of Psychological Assessment Inventory in Patients with Functional Constipation

目的　探討功能性排便障礙人群心理評估中心理和情緒的變化。方法　采用SCL-90、SAS和SDS量表對72例功能性排便障礙患者進行心理評估并分析結果。結果　便秘組SCL-90測試的總分以及軀體化、抑郁、焦慮及精神病性這4項因子的評分結果均高于對照組（P＜0.001），2組其余各因子的評分結果差異沒有統計學意義（P＞0.05）。便秘組SAS和SDS測試的評分結果均高于對照組，表明便秘組焦慮和抑郁的評分均較對照組高（P＜0.001）。結論　功能性便秘患者不同程度伴隨有情緒和情感的異常，因此對該部分患者進行藥物干預的同時給予其心理輔導是非常有必要的。

腹部按摩護理改善COPD合并便秘患者的癥狀評分觀察

摘要:目的:觀察腹部按摩護理對慢性阻塞性肺疾病(COPD)合并便秘患者的癥狀評分影響。方法:61例COPD合并便秘患者住院期間接受了腹部按摩護理干預(由下腹回盲部開始,沿結腸走向,從右至左環行按摩,力度適中,3次/d,5～10 min/次),干預前后進行“便秘癥狀及療效評估問卷”評分。結果:入選對象干預后便秘癥狀總分(10.06±2.93)明顯低于干預前(12.77±3.40),Plt;0.05),同時他們便秘癥狀的各分項評分指標也明顯優于治療前(P均lt;0.05～0.01)。結論:腹部按摩護理可明顯改善COPD合并便秘患者的癥狀評分。

舒適護理在腰椎間盤突出臥床患者便秘中的應用

目的評價舒適護理應用于腰椎間盤突出患者臥床期間便秘中的效果，探討其臨床適用性。 方法將2013年5月-2014年5月就診的67例腰椎間盤突出患者隨機分為研究組（34例）和對照組（33例）。對照組患者實施常規護理，研究組患者在常規護理的基礎上增加了有針對性的膳食指導、心理疏導、腹部按摩、溫水洗肛及訓練反射性排便等舒適護理干預。觀察并記錄兩組患者治療后一般情況及干預療效。 結果接受護理干預的34例患者的術后首次排便時間、平均排便相隔時間和平均每次排便時間均低于對照組，差異有統計學意義（P＜0.05），研究組患者的護理干預療效高于對照組，差異有統計學意義（χ2=4.831， P=0.028）。 結論舒適護理對腰椎間盤突出患者臥床期間便秘中有很好的干預效果。

結腸透析治療慢性重癥乙型肝炎患者便秘及腹脹的護理

目的　總結結腸透析治療慢性重癥乙型肝炎患者便秘及腹脹的護理方法及療效。 方法　對2010年7月－2011年7月45例慢性重癥乙型肝炎合并便秘及腹脹患者結腸透析治療中，所采用的護理措施及效果進行回顧性分析。 結果　45例患者一個療程結束后，其中10例便秘及8例腹脹癥狀緩解顯著，13例便秘及10例腹脹癥狀有所緩解，2例便秘及2例腹脹患者癥狀無改善。 結論　結腸透析對治療慢性重癥乙型肝炎患者便秘及腹脹一定療效，是一條新的治療途徑。

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

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. ConclusionLung 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.

Efficacy of Chinese Herbal Medicines in Treating Chronic Functional Constipation: A Systematic Review

Objective　To assess the efficacy and safety of Chinese herbal medicines for chronic functional constipation. Methods　We searched CNKI (1989 to November, 2009), CBM (1989 to November, 2009), VIP (1989 to November, 2009), Cochrane Library (Issue 4, 2009), PubMed (1966 to November, 2009) and EMbase (1986 to November, 2009). All randomized and quasi-randomized clinical trials of treating chronic functional constipation with Chinese herbal medicines versus untreated, placebo or western drug groups were included. Data were extracted independently by two reviewers. The methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria. Meta-analyses were conducted by the RevMan 5.0 software. Results　Twenty-one trials involving 2 602 patients were included. The Meta-analysis results showed that: Chinese herbal medicines improved both syndromes and colonic transit function of recipients; moreover, it is superior to both gastrointestinal prokinetic agent in effective rate (RR=1.18, 95%CI 1.12 to 1.25), healing rate (RR=1.59, 95%CI 1.35 to 1.88), and cathartic in effective rate (RR=1.18, 95%CI 1.10 to 1.27), healing rate (RR=1.16, 95%CI 1.29 to 2.10). Integration of Chinese herbal medicines and gastrointestinal prokinetic agent is superior to gastrointestinal prokinetic agent in effective rate (RR=1.21 95%CI 1.09 to 1.34) and healing rate (RR=1.41, 95%CI 1.11 to 1.79). Conclusion　Some Chinese herbal medicines may be effective and safe in treating chronic functional constipation, which can not be bly proved at present for lack of studies with high quality.