肺癌患者术后住院期间便秘现状及其影响因素分析

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

目的调查肺癌患者术后住院期间便秘现状及出院时仍存在中重度便秘的影响因素。方法选取2017年11月—2020年1月在四川省6家三级医院接受手术的肺癌患者。采用MD安德森症状评估量表-肺癌子表收集患者术后便秘的评分情况。采用非条件logistic逐步回归分析出院当天仍存在中重度便秘的影响因素。结果纳入337例患者,其中男171例、女166例,平均年龄(55.0±10.3)岁。肺癌患者术后第1~3 d便秘评分逐日递增,术后第3~7 d便秘评分整体呈递减趋势。出院当天有68例(20.2%)患者存在中重度便秘,术后住院时间(OR=0.743,P<0.001)和术后住院期间吗啡使用剂量(OR=1.002,P=0.015)是其影响因素。结论肺癌患者术后第3 d便秘最严重。出院当天中重度便秘与术后住院时间和术后住院期间吗啡使用剂量有关。

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.Conclusion Lung 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.