沟通达标教育结合穴位按摩在阿片类药物性便秘患者中的应用

孙红; 方莉亚; 卜亚美; 郑云霞; 蔡建利

doi:10.16766/j.cnki.issn.1674-4152.003687

沟通达标教育结合穴位按摩在阿片类药物性便秘患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003687

1.
湖州市第一人民医院胃肠外科，浙江湖州 313000
2.
湖州市第一人民医院护理部

基金项目:

浙江省医药卫生科技计划项目 2022ZH055

湖州市科技技术局公益性应用研究项目 2020GYB50

详细信息

通讯作者:
孙红，E-mail：sunhong9261985@163.com

中图分类号: R442.2 R473.6
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- 文章访问数: 20
- HTML全文浏览量: 8
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-03-18

Application of communication standard education combined with acupressure in patients with opioid constipation

1.
Department of Gastrointestinal Surgery, Huzhou First People ' s Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的探讨沟通达标教育干预联合穴位按摩对阿片类药物性便秘(OIC)患者疾病认知、胃肠活动和便秘的影响。方法选取2020年12月—2023年11月湖州市第一人民医院肿瘤科收治的120例OIC患者为研究对象，采用随机数字表法分为对照组与观察组，每组60例。对照组给予常规护理干预，观察组给予沟通达标教育结合穴位按摩干预。比较2组护理干预前后疾病认知、胃肠电图仪参数及便秘症状的变化。结果对照组1例失访，观察组2例因转院退出，最终对照组59例、观察组58例完成研究。观察组干预后疾病认知率均高于对照组(P＜0.05)；观察组升结肠波幅及蠕动频率为(139.45±20.34)μV、(7.90±1.56)次/min，横结肠波幅及蠕动频率为(140.77±17.21)μV、(7.90±1.44)次/min，均高于对照组的(120.34±15.27)μV、(6.77±1.24)次/min、(129.45±15.23)μV、(6.88±1.27)次/min(P＜0.05)；观察组克利夫兰便秘评分量表评分为(8.11±1.01)分，低于对照组的(11.34±2.14)分(P＜0.05)；观察组Bristol大便性质分级优于对照组(P＜0.05)。结论沟通达标教育结合穴位按摩可改善OIC患者疾病认知情况，加快胃肠蠕动，缓解便秘。
- 阿片类药物性便秘 /
- 中西医结合护理 /
- 穴位按摩 /
- 沟通达标理论 /
- 胃肠电图仪
Abstract: Objective To explore the effects of communication standard education intervention combined with acupressure on disease cognition, gastrointestinal activity and constipation in patients with opioid-induced constipation (OIC). Methods A total of 120 OIC patients admitted to the Oncology Department of Huzhou First People ' s Hospital from December 2020 to November 2023 were selected as the study objects. They were divided into control groups and experimental group by random number table method, with 60 cases in each group. The control group was given routine nursing intervention, and the experimental group was given communication standard education combined with acupressure intervention. The changes of disease cognition, gastroenterogram parameters and constipation symptoms before and after nursing intervention were compared between the two groups. Results One case in the control group was lost to follow-up, and two cases in the experimental group withdrew due to transfer to another hospital. Finally, 59 cases in the control group and 58 cases in the experimental group completed the study. The disease recognition rate of experimental group was higher than that of control group after intervention (P < 0.05). Ascending colon amplitude and peristalsis frequency were (139.45±20.34) μV, (7.90±1.56) times/min, transverse colon amplitude and peristalsis frequency were (140.77±17.21) μV, (7.90±1.44) times /min. Those were higher than control group [(120.34±15.27) μV, (6.77±1.24) times/min, (129.45±15.23) μV, (6.88±1.27) times/min, P < 0.05]. The score of Cleveland constipation rating scale was (8.11±1.01) points, which was lower than that of control group [(11.34±2.14) points, P < 0.05]. Bristol stool quality grade was better than control group (P < 0.05). Conclusion Communication standard education intervention combined with acupoint massage can improve disease cognition, accelerate gastrointestinal activity and relieve constipation in OIC patients.
- Opioid-induced constipation /
- Nursing of integrated Chinese and Western medicine /
- Acupressure /
- Communication standard theory /
- Gastroenterograph
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表 1 2组OIC患者一般资料比较

Table 1. Comparison of general data between two groups of OIC patients

组别	例数	性别(男/女, 例)	年龄(x±s, 岁)	BMI(x±s)	癌症类型(肺癌/胃癌/肝癌/乳腺癌/宫颈癌/其他, 例)	阿片类药物(可卡因/吗啡/羟考酮, 例)	KPS评分(x±s, 分)
对照组	59	38/21	56.77±8.10	22.45±3.44	18/10/7/10/8/6	10/9/40	68.99±8.12
观察组	58	33/25	57.09±5.13	22.30±4.38	19/11/9/8/7/4	14/10/34	68.56±6.13
统计量		0.691^a	0.255^b	0.206^b	0.898^a	1.197^a	0.323^b
P值		0.406	0.799	0.837	0.826	0.550	0.747
注：^a为χ²值，^b为t值。

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表 2 2组OIC患者干预前后疾病认知情况比较(例)

Table 2. Comparison of disease cognition before and after intervention between two groups of OIC patients (cases)

组别	例数	时间点	OIC症状和危害性	合理饮食	运动知识	药物干预
对照组	59	干预前	22	21	24	28
		干预后	30	31	34	32
观察组	58	干预前	20	24	21	22
		干预后	46^ab	47^ab	49^ab	46^ab
组间		Waldχ²	26.789	38.254	79.013	18.235
		P值	0.008	0.004	＜0.001	0.004
时间		Waldχ²	112.340	89.234	157.880	50.918
		P值	＜0.001	＜0.001	＜0.001	＜0.001
交互		Waldχ²	98.562	67.091	130.231	37.231
		P值	＜0.001	＜0.001	＜0.001	＜0.001
注：与同组干预前比较，^aP＜0.05；与对照组比较，^bP＜0.05。

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表 3 2组OIC患者干预前后胃肠电图仪参数比较(x±s)

Table 3. Comparison of ECG parameters before and after intervention between two groups of OIC patients(x±s)

组别	例数	升结肠波幅(μV)		升结肠蠕动频率(次/min)		横结肠波幅(μV)		横结肠蠕动频率(次/min)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	59	109.34±10.23	120.34±15.27^b	5.90±1.12	6.77±1.24^b	105.67±14.88	129.45±15.23^b	5.78±0.90	6.88±1.27^b
观察组	58	108.88±15.27	139.45±20.34^b	5.86±0.96	7.90±1.56^b	105.77±19.23	140.77±17.21^b	5.85±1.33	7.90±1.44^b
统计量		0.192^a	8.907^c	0.207^a	7.457^c	0.031^a	9.096^c	0.334^a	6.124^c
P值		0.848	＜0.001	0.836	＜0.001	0.975	＜0.001	0.739	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 4 2组OIC患者干预前后CCS评分比较(x±s, 分)

Table 4. Comparison of CCS scores between groups of OIC patients(x±s, points)

组别	例数	干预前	干预后
对照组	59	14.56±2.36	11.34±2.14^b
观察组	58	14.22±3.10	8.11±1.01^b
统计量		0.668^a	18.234^c
P值		0.505	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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表 5 2组OIC患者干预前后Bristol大便性质分级比较(例)

Table 5. Comparison of Bristol stool nature grade before and after intervention between two groups of OIC patients before and after intervention(cases)

组别	例数	时间点	Ⅰ型	Ⅱ型	Ⅲ型	Ⅳ型	Ⅴ型	Ⅵ型	Ⅶ型
对照组	59	干预前	13	27	19	0	0	0	0
		干预后	2	15	18	9	13	2	0
观察组	58	干预前	14	25	19	0	0	0	0
		干预后	0	5	6	18	20	9	0

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