髋部骨折患者伤后30d内便秘发生情况调查

Investigation on Constipation during the First 30 Days after Hip Fracture

目的研究髋部骨折患者骨折后30 d内的便秘发生情况。方法纳入2014年5月-2015年3月共104例髋部骨折患者,记录患者入院至手术前、手术后至出院、出院后至伤后30 d这3个时间段的排便形态和有无排便困难,以判断有无便秘,其中大便形态根据布里斯托大便分类法标准评定,有无排便困难根据4阶段排便模式评定。结果 54例（51.9%）患者在入院至手术前有便秘,69例（69.0%）患者在手术后至出院期间便秘,而伤后30 d仍有59例（63.4%）患者便秘。从入院到出院的2个时间段,髋部骨折患者便秘的比例差异有统计学意义（P=0.003）,而手术后到伤后30 d两个时间段便秘比例差异无统计学意义（P=0.581）。患者平均手术后9.7 d（1-30 d）恢复至伤前的解便规律。截至伤后30 d随访,仍有22例（23.7%）患者解便规律仍未恢复。结论髋部骨折患者伤后30 d便秘比例较高,需进一步研究如何干预髋部骨折患者便秘的发生。

Objective To research on the condition of constipation during the first 30 days after hip fracture.Methods One hundred and four patients with hip fracture treated between May 2014 and March 2015 participated in this study.We judged whether there was constipation by recording the defecation pattern and stool consistency in three time periods：from admission to the time just before surgery,from the end of surgery to the time of discharge,and from discharge to 30 days after injury.The defecation pattern was assessed using Bristol Stool Scale and a scale of fourstage defecation was used to assess the stool consistency.Results There were 51.9%（54） of the patients who developed constipation during the first time period,69.0%（69） during the second time period,and 63.4%（59） in the third time period.The proportion increased by 17%during the second period over the first（P= 0.003）,while there was no significant difference between the latter two time periods（P= 0.581）.Normal defecation pattern was re-established 9.7 days after surgery,though 23.7%（22） of the patients did not re-establish normal defecation pattern within the first 30 days after injury.Conclusions The incidence of constipation during the first 30 days after hip fracture is high.The results imply that further studies are needed to prevent constipation.