饮食教育预防骨科术后病人便秘的研究

The effect of diet education on preventing constipation among orthopedic inpatients

目的 :探讨饮食教育对骨科术后病人进食结构的影响 ,预防便秘的发生。方法 :将骨科择期手术的 116例术后病人随机分为实验组 5 7例 ,对照组 5 9例。实验组于术前 1d及术后第 2日分 2次接受专门的饮食教育 ,对照组接受常规指导。记录病人术后 6d内的进食种类、量及排便情况。结果 :实验组术后第 1、2日主食进食量及第 3日蔬菜进食量均明显高于对照组 (t =2 .33、2 .0 2、2 .0 2 ,P均 <0 .0 5 ) ;术后便秘评分 ,实验组 3.0 6± 3.6 1,对照组 5 .0 4± 3.6 2 (t=2 .99,P <0 .0 5 ) ;与便秘相关的多因素的多元线性逐步回归分析显示 ,术后第 1日主食量与术后便秘评分呈直线负相关。结论 :对病人进行饮食教育能够有效降低骨科术后病人便秘评分 ,即饮食教育能够降低术后便秘的发生 ;饮食结构不合理可能主要由术后主食类、蔬菜类的量不足造成。因此进行饮食教育时应强调术后适宜的主食量和蔬菜量 ,特别应重视病人术后第 1日的进食情况。

Objective: To study the effect of diet education on preventing constipation among orthopedic inpatients, and the relationship between diet education and food-taking pattern of postoperative patients. Methods:116 orthopedic inpatients who have been operated on spine, hip joint or lower extremity were randomly divided within 2 groups, which including study group ( n =57) and control group( n =59).Patients in study group were given diet education preoperatively and in the second day after operation. Patients in control group were given no intervention. The data collected include the sorts and amounts of food taken in the six days after operation and defecation score. Results: The amount of staple food in the first and second day after operation, and the amount of vegetable in the third day after operation taken by patients in study group higher than those taken by patients in control group(study group vs. control group: t =2.33,2.02,2.02, all P <0.05).Defecation scores of patients in study group(3.06±3.61) lower than those of patients in control group(5.04±3.62, study group vs. control group: t =2.99, P <0.05). The possible factors related to constipation were analyzed with multivariate linear stepwise regression analysis. The results showed that only the amount of staple food in the first day after operation was negatively related to constipation. Conclusion: Diet education can prevent constipation of these patients after operation. The inadequate amount of staple food and vegetable was the main unreasonableness that exists among these patients. So the adequate amount of staple food and vegetable should be emphasized when diet education is given and we should take the condition of patients' taking food more serious in the first day after operation.