急性脑卒中病人排便情况的影响因素分析

Analysis of factors influencing defecation in patients with acute stroke

[目的]探讨急性脑卒中病人排便情况及其影响因素。[方法]选取陆军军医大学大坪医院神经内科住院的急性脑卒中病人200例,调查病人的一般资料、饮食、便秘情况、大便性状、美国国立卫生研究院卒中量表(NIHSS)评分和卒中危险因素,分析影响其排便的因素。[结果]急性脑卒中发病后首次排便便秘的发生率为36.5%,首次排便情况与诊断、NIHSS评分及进食方式有关(P<0.05)。病人后续排便的便秘发生率为39.5%、便秘后腹泻发生率为12.7%,后续排便情况与NIHSS评分、进食方式及干预方式有关(P<0.05)。[结论]神经功能受损情况是影响急性脑卒中病人排便的主要因素。对于卒中后便秘,药物干预总体效果差,便秘严重者采取口服缓泻剂与灌肠通便均不能缓解后续便秘状况,且增加了腹泻的风险。

Objective:To investigate the defecation situation and its influencing factors in patients with acute stroke.Methods:A total of200patients with acute stroke,admitted to the department of neurology of Daping Hospital of Army Military Medical University,were selected to investigate the general data,diet,constipation,defecation,NIHSS score and risk factors of stroke,and the factors influencing their defecation were analyzed.Results:The incidence of first constipation after acute stroke was36.5%.The first defecation was related to diagnosis,NIHSS score and feeding ways(P<0.05).The incidence of consequent constipation was39.5%and the incidence of diarrhea was12.7%.Consequent defecation was related to NIHSS score,feeding ways and the was of intervention(P<0.05).Conclusions:Impaired nerve function was the main factor affecting defecation in patients with acute stroke.For patients with post stroke constipation,the overall effect of drug intervention was poor.For those with severe constipation,taking oral laxative agent and enema for defecation could not relieve the subsequent constipation,and increase the risk of diarrhea.