肺癌患者术后便秘的现状及影响因素

Investigation of postoperative constipation in patients with lung cancer and analysis of its influencing factors

目的调查肺癌患者术后便秘的发生现状,分析导致术后便秘发生的影响因素。方法研究对象78例,均为苏州市立医院2020年3月至2023年2月期间收治的接受肺癌手术的患者,根据罗马Ⅳ标准制定术后患者便秘诊断标准,根据诊断结果将患者分为观察组(发生便秘)和对照组(未发生便秘),对患者的资料进行收集和对比,通过单因素分析、Logistic多因素分析导致术后便秘发生的危险因素,并提出相应护理对策。结果78例接受肺癌手术的患者术后有22例发生便秘,便秘的发生率为28.20%(22/78);两组年龄、性别、术前TNM分期、麻醉分级、体重指数、高血压、糖尿病对比差异无统计学意义(均P>0.05);两组术后疼痛评分高、机械通气、使用肠内营养、术后制动时间较长、拒绝在床上排便、有便秘史、镇痛药物使用时间、术后发生谵妄对比差异有统计学意义(P<0.05);通过多因素Logistic回归分析,镇痛药物使用时间、术后制动时间较长、拒绝在床上排便为肺癌术后患者发生便秘的主要危险因素(P<0.05)。结论由于患者存在个体差异,镇痛药物使用时间、术后制动时间较长、拒绝在床上排便增加患者术后便秘的发生风险,针对该危险因素进行预防和护理,以降低肺癌患者术后便秘的发生率,促进患者恢复。

Objective To investigate the status quo of postoperative constipation in patients with lung cancer and analyze the influencing factors of postoperative constipation.Methods The subjects of this study were 78 patients who underwent surgery for lung cancer admitted to the hospital from March 2020 to February 2023.The diagnostic criteria for postoperative constipation were formulated according to RomeⅣcriteria,and the patients were divided into observation group(with constipation)and control group(without constipation)according to the diagnostic results.The data of the patients were collected,the two groups of data were compared,and the risk factors leading to postoperative constipation were analyzed by univariate analysis and Logistic multi-factor analysis,and the corresponding nursing countermeasures were proposed.Results Postoperative constipation occurred in 22 of 78 patients who underwent lung cancer surgery,and the incidence of constipation was 28.20%(22/78).There were no significant differences in age,sex,preoperative TNM stage,anesthesia grade,body mass index,hypertension and diabetes between the two groups(P>0.05).There were statistically significant differences between the two groups in postoperative pain score,mechanical ventilation,use of enteral nutrition,longer postoperative braking time,refusal to defecate in bed,history of constipation,duration of sedation and postoperative delirium(P<0.05).Multivariate logistic regression analysis showed that the duration of analgesic drug use,long postoperative braking time and refusal to defecate in bed were the main risk factors for constipation in patients with lung cancer after surgery(P<0.05).Conclusions Due to individual differences in patients,the duration of analgesic drug use,longer postoperative braking time,and refusal to defecate in bed increase the risk of postoperative constipation in patients.Prevention and care should be carried out according to these risk factors,so as to reduce the incidence of postoperative constipation in patients with lung cancer and promote their recovery.