骶2至骶4脊髓反射区按摩联合扩肛疗法对脑卒中后便秘患者的影响

Influence of combining therapy of massage on sacro-2 to sacro-4 spinal cord reflexion area and anal dilatation therapy on patients of constipation after cerebral apoplexy

目的探讨骶2至骶4脊髓反射区按摩联合扩肛疗法对脑卒中后便秘患者的影响,促进脑卒中后便秘患者的排便功能康复。方法采用随机对照研究方法,便利抽样法选取广州医科大学附属中医医院2018年8月至2019年7月收治的80例脑卒中后便秘患者为研究对象,按随机数字表法将入组患者分为观察组与对照组各40例。在常规便秘相关的护理措施基础上,对照组予扩肛疗法,观察组予骶2至骶4脊髓反射区按摩联合扩肛疗法。比较2组患者干预前后便秘疗效、便秘症状评分及神经功能缺损程度。结果观察组男22例,女18例;年龄40~75(63.33±8.49)岁;对照组男23例,女17例,年龄41~74(63.03±7.60)岁。干预前,2组的便秘症状评分、神经功能缺损情况比较,差异均无统计学意义(均P>0.05);干预后,观察组便秘症状评分、神经功能缺损情况评分分别为(3.80±2.05)、(7.58±2.69)分,均明显低于对照组的(5.18±3.52)、(8.90±2.73)分,2组比较差异均有统计学意义(t=-2.13、-2.19,均P<0.05),观察组便秘疗效的总有效率为97.50%(39/40),高于对照组的87.50%(35/40),2组比较差异有统计学意义(χ^(2)=-2.11,P<0.05)。结论骶2至骶4脊髓反射区按摩联合扩肛疗法对脑卒中后便秘患者的护理干预能够有效减轻患者的便秘症状,降低神经功能缺损评分,有利于脑卒中患者排便功能康复。

Objective To investigate the influence of combining therapy of massage on sacro-2 to sacro-4 spinal cord reflexion area and anal dilatation therapy on constipation after cerebral apoplexy and promote the rehabilitation of defecation function in patients with constipation after stroke.Methods Aandomized controlled study method was chosen,80 patients with constipation after cerebral apoplexy treated in Guangzhou Traditional Chinese Medicine Hospital from August 2018 to July 2019 were selected as research subjects by convenience sampling.The enrolled patients were divided into 2 groups,40 to the observation group and 40 to the control group by random number table method.On the basis of routine constipation related nursing measures,the control group was given anal dilatation therapy,while the observation group′s treatment was given massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anal dilatation therapy.Before intervention and after intervention,the changes of therapeutic effect of constipation effect,constipation symptoms scores and the degree of neurological deficit were all compared between the two groups.Results There were 22 males and 18 females in the observation group;age ranged from 40 to 75(63.33±8.49)years old;in the control group,there were 23 males and 17 females,aged 41-74(63.03±7.60)years old.Before intervention,there was no statistically significant difference in constipation symptom scores and neurological deficits between the two groups(both P>0.05).After intervention,the score of constipation symptoms was(3.80±2.05)points and the score of the degree of neurological deficit was(7.58±2.69)points in the observation group,both lower than(5.18±3.52)points and(8.90±2.73)points in the control group with statistically significant differences between the two groups(t values were respectively-2.13 and-2.19,both P<0.05).The total efficacy of the observation group was 97.50%(39/40),which was significantly higher than 87.50%(35/40)of the control group with statistically significant differences between the two groups(χ^(2)=-2.11,P<0.05).Conclusions Nursing intervention of massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anus dilatation therapy on constipation after cerebral apoplexy can effectively reduce the symptoms of constipation and lowered the degree of neurological deficit,which is beneficial to the functional rehabilitation of patients with cerebral apoplexy.