老年人功能性便秘的原因分析和护理对策

目的 分析老年患者功能性便秘的原因并探讨有效的护理方法.方法 对78例经检查排除结肠、直肠器质性病变的老年功能性便秘的发生原因进行分析及护理探索.结果 发生便秘的原因有饮食、药物因素、不良排便习惯以及少运动.构成比分别为25.64%,19.23%,23.08%,26.92%,经过针对性护理,15.38%转为正常,58.97%病情好转.结论 针对功能性便秘的发生原因进行相应的护理和指导,起到较好的效果.     

老年内科患者便秘的原因分析与护理

目的　探讨预防老年患者便秘的护理。方法　对 118例内科老年患者便秘的原因进行分析。结果　通过对老年患者进行心理、饮食、药物等指导 ,解除了便秘痛苦。结论　护理干预有效降低了便秘的发生     

中医护理对老年慢性功能性便秘患者的效果探讨

目的探究中医护理在老年慢性功能性便秘患者中应用的效果。方法研究时间是2019年1月-2020年1月,研究对象为本院收治的56例老年慢性功能性便秘患者,回顾和分析所有研究对象的临床资料,以数字随机法为原则,将所有研究对象平均分成对照组和研究组,单组样本量28例。对照组应用常规护理方案,研究组应用中医护理,对比两组护理方法对老年慢性功能性便秘患者的效果以及患者的护理满意度。结果护理后研究组自发排便次数、便秘症状评分、伴随症状评分均低于对照组(P<0.05);护理后生活质量对比,一般健康状况、生理功能、生理职能、躯体疼痛、精力、社会功能、情感职能以及精神健康评分研究组均高于对照组(P<0.05)。研究组患者的护理总有效率为96.42%,大于对照组(64.28%),数据对比差异明显,P=0.0024<0.05,且研究组患者的护理满意度高于对照组(96.42%>71.42%),P=0.0108<0.05,研究存在统计学意义。结论中医护理在老年慢性功能性便秘患者中有较理想的应用效果,值得广泛应用。     

长期住院老年精神病患者便秘的原因与护理

目的分析长期住院老年精神病患者产生便秘的原因,有针对性的采取护理措施。方法对156例长期住院老年精神病患者进行排便情况的回顾性统计分析。结果长期住院老年精神病患者便秘的发生率为64.36%。结论对于长期住院老年精神病便秘患者给予及时有效的护理干预十分重要。     

“治未病”方案对老年功能性便秘患者护理效果的观察

目的观察并评价"治未病"护理方案对老年功能性便秘患者的实施效果。方法将镇江市中西医结合医院2017年8月至2018年4月诊治为功能性便秘的老年患者42例,按就诊先后顺序随机分为观察组和对照组各21例,对照组患者采用常规护理(饮食管理、活动管理、常规健康教育);观察组患者采用"治未病"护理方案,即根据患者的生活、饮食习惯、情志等因素了解、收集护理需求,通过症状、情绪、生活、信息等方面进行全面管理。对两组患者定期随访,第6个月时采用便秘生活质量量表(PAC-QOL)、便秘症状量化评分表、护理满意度评估问卷对两组患者进行护理效果评价及比较分析。结果观察组患者便秘症状评分明显降低,和对照组比较差异有统计学意义(P0.05);观察组在生理不适、社会心理不适、担忧等得分都明显低于对照组,差异有统计学意义(P0.05);对照组满意率为61.90%,观察组满意率为90.48%,观察组高于对照组(P0.05)。结论 "治未病"护理方案可以辅助改善老年功能性便秘患者便秘症状,提高预防保健能力满意度,提升患者生活质量。     

耳穴压豆对老年功能性便秘的护理效果分析

目的:研究老年功能性便秘患者实施耳穴压豆的护理效果。方法:我院选择2013年5月-2015年5月间诊治的166例老年功能性便秘患者,根据治疗方法不同将其均分为两组,对照组的86例患者运用酚酞片口服进行治疗,观察组患者运用耳穴压豆取穴进行治疗,比较两组患者的治疗效果。结果:通过比较,观察组患者的有效率为93.0%,对照组为65.1%,两组患者差异显著,有统计学意义(P0.05)。结论:老年功能性便秘患者运用耳穴压豆方法治疗的临床效果显著,患者无不良反应出现,适合在临床上推广应用。     

中医护理对老年慢性功能性便秘知识知晓率及护理满意率的影响分析

目的:研究中医护理对老年慢性功能性便秘知识知晓率及护理满意率的影响.方法:选取我院96例(2016年1月28日到2017年1月25日期间)老年慢性功能性便秘患者为本次的研究对象,采用随机分组原则,将患者分为观察组、对照组两组,每组患者48例,对照组患者给予常规护理干预,观察组患者在对照组的基础上进行饮食、情绪、运动、用药、宣教等方面进行护理.结果:经过一段时间的中医护理,观察组患者的饮食调理、情绪调控、适量运动、合理用药、危害认识等情况明显多于对照组,观察组总满意度97.91％,显著高于对照组总满意度70.08％,两组差异显著.结论:针对老年慢性功能性便秘进行中医护理,对提高患者的便秘知识知晓率及护理满意率具有非常显著的效果.     

老年慢性功能性便秘的护理进展

功能性便秘是老年人常见的健康问题。便秘指排便次数7d内少于2～3次，粪便量少、干硬并伴排出困难。功能性便秘则指非器质性或药物因素所致的便秘。老年人因全身肌肉张力减退、咀嚼功能和消化功能下降以及不良的生活方式等易发生功能性便秘。我国北京地区的调查显示，65岁以上老年人的便秘发生率高达30％，其中女性多见，为男性的4倍。便秘可导致腹胀、腹痛、头痛、头晕以及食欲不振等不适。严重便秘的老年患还可发生粪便嵌顿、痔疮、肛裂、甚至诱发心绞痛和脑血管意外，从而危及其健康和生命，损害其生活质量。目前，有较多研究致力于探讨老年慢性功能性便秘的发生机制、危害、危险因素和有效的护理干预措施。本就以上几个方面作一综述，为临床护理和相关的护理研究提供参考。     

护理干预对老年功能性便秘患者生活质量的影响

目的 探讨护理干预对老年功能性便秘患者生活质量的影响.方法 选择2009年2月~2011年8月我院收治的老年功能性便秘患者44例,在治疗基础上采用积极的综合干预措施,包括健康教育、心理指导、生物反馈训练等.结果 经过干预后,本组患者总有效率为93.8%.本组患者干预前的生活质量总分为(49.62±6.58),明显少于常模的(67.52±4.89)(P < 0.05),干预后为(65.25±9.52),与常模相近(P > 0.05).结论 在老年功能性便秘患者中,护理干预的应用不仅能使临床症状得到有效改善,还可使患者的生活质量大大提高.     

COPD老年患者便秘的原因及护理干预

慢性阻塞性肺疾病（COPD）老年患者在临床上绝大多数会出现便秘,可使病情加重,影响预后。本文分析了住院COPD老年患者便秘的原因,并提出了护理干预的方法,旨在尽可能地解除患者因便秘而产生的躯体、心理不适,对提高COPD老年患者的生命质量、防止并发症的发生、促进早日康复有重要意义。     

美常安联合乳果糖治疗慢性功能性便秘的疗效观察

目的评价美常安联合乳果糖治疗慢性功能性便秘的疗效。方法采用随机、双盲、平行的方法将慢性功能性便秘患者83例分为三组,A组(n=31)口服美常安+乳果糖,B组(n=27)口服美常安,C组(n=25)口服乳果糖,疗程4 w。结果治疗4 w后,三组总有效率分别为96.8%,44.4%,72.0%。A组显著高于B和C两组(p<0.05)。结论美常安联合乳果糖治疗慢性功能性便秘优于单用一种药物,且效果明显,安全、有效,值得临床推广应用。     

Chronic functional constipation in adolescents: clinical findings and motility studies

OBJECTIVE: To evaluate the clinical findings and colonic transit time in adolescents with chronic functional constipation. METHODS: Forty-eight consecutive adolescents with chronic functional constipation referred to the Gastroenterology Service at the Hospital de Clínicas de Porto Alegre, Brazil were studied. Clinical parameters were assessed using a questionnaire. Total and segmental colonic transit time were measured with radiopaque markers. RESULTS: Mean age at first visit was 14 +/- 2 years, and age at onset of constipation was 6 +/- 4 years; 90% of patients depended on laxatives, and 86% on intermittent enemas; 76% had a family history of constipation. There was no statistical difference in the amount of daily fiber ingested by patients and controls. Measurements of colonic transit time revealed that 60% of patients had slow transit constipation, 13% had pelvic floor dysfunction, 10% had slow transit constipation associated with pelvic floor dysfunction, and 17% had a normal colonic transit time. Decreased frequency of evacuation and palpable abdominal fecal mass were significantly associated with slow transit constipation. CONCLUSIONS: Functional constipation in adolescence consists of a heterogeneous group of colonic functional disorders. The identification of these different functional disorders in adolescents will guide specific treatment, which may prevent the progression of this symptom into adult life.     

Chronic constipation in childhood. A report of 78 patients

AIM: To assess the aetiology and the clinical patterns of chronic constipation in children. METHODS: A total of 78 patients (62% boys, mean age: 4.6 years) were enrolled in this retrospective study. For each patient, we collected these data: clinical features, radiological data, rectal manometry and rectal biopsy results, treatment and follow up. RESULTS: Functional constipation was the most frequent cause of chronic constipation (49 cases, 62.8%) followed by Hirschsprung's disease (19 cases, 24.3%). Rectal manometry, performed in all suspected Hirschsprung's disease, concluded to the absence of inhibitory rectoanal reflex in 17 of them. Rectal biopsy concluded to segmental absence of parasympathetic ganglion cells in eleven of them. Therapeutic approach consists of treatment of functional constipation by laxatives, enemas and dietary fibers in respectively 22, 12 and 6 children. Two other patients had a biofeedback re-education. Treatment was successful in 9 patients and unsuccessful in 2 others. Seven children with Hirschsprung's disease underwent Soave's (n = 3), Swenson's (n = 3) and Duhamel's procedures (n = 1). Outcome was favourable in five of them and complicated by stenosis in 2 others. CONCLUSION: Our study suggests that functional constipation is the most frequent cause of chronic constipation in children and that Hirschsprung's disease is the first organic cause of chronic constipation indicating the need of rectal manometry for diagnostic confirmation.     

插管注入开塞露在妇科便秘患者中的应用

目的:探讨插管注入开塞露对缓解妇科患者便秘的效果。方法:将140例妇科便秘患者随机分为对照组和试验组各70例,对照组采用传统的方法将开塞露直接纳肛,试验组用50ml注射器连接16号吸痰管轻插入肛门15-20cm,注入同等量开塞露通便,比较两者患者用药效果。结果:实验组患者排便时间明显比对照组提前(P<0.01);实验组排便效果优于对照组,差异有显著意义(P<0.01)。结论:插管注入开塞露纳肛在缓解妇产科便秘患者中安全、实用、可靠,优于传统方法。     

功能性便秘肛门直肠动力学和敏感性研究

目的：探讨功能性便秘（FC）患者肛门直肠动力学和直肠感觉特征。方法：采用肛门直肠测压方法检测44例FC患者的肛门直肠静息压、缩榨压、直肠初始感觉阈值、排便感觉阈值、窘迫感觉阈值和最大耐受容量指标,并与14例健康人做对照。结果：FC患者肛门静息压、最大缩榨压均较对照组明显降低,差异有显著性（P〈0.05）;但FC患者的初始感觉阈值、排便阈值、窘迫阈值和最大耐受容量均高于对照组（P〈0.05）。模拟排便时,FC组31.82%的患者在直肠收缩时伴有肛管括约肌的矛盾收缩。结论：功能性便秘患者存在肛门直肠动力和感觉异常,可能与FC发病相关。     

Assessment of constipation management in long-term care patients

OBJECTIVES: To determine the prevalence of diagnosed constipation among nursing home patients; to assess the prevalence of routine (at least one time per week for 4 consecutive weeks) laxative use; and to investigate prescribing practices. DESIGN: A retrospective multi-center medical record evaluation. SETTING: Any one of 25 nursing facilities representative of a long-term care pharmaceutical provider's geographical coverage. PARTICIPANTS: All patients under the age of 65, and/or who had resided in the facility for less than 4 weeks, and/or who were placed in a specialty care bed (eg, Alzheimer's disease, hospice, HIV/AIDS) were excluded. RESULTS: A total of 712 resident charts meeting initial inclusion criteria were screened, 392 (55%) of which had a documented diagnosis of constipation and/or routine laxative use. Approximately 28% (CI +/- 3.3) of residents had a documented diagnosis of constipation. The rate of laxative use within the same sample population of 712 patients was 53.8% (CI +/- 3.7). Of the 392 patients with a diagnosis of constipation and/or routine laxative use, over 72% had at least one diagnosis or medication known to precipitate constipation. The most commonly prescribed laxatives were stool softeners (26.2%), saline laxatives (18.4%) and stimulant/irritant laxatives (15.6%). Almost half of the laxative users were prescribed more than one agent. CONCLUSION: This study supports the concern that there is often a gap between documentation of symptoms and constipation treatment decisions. No correlation was found between the specific laxative prescribed and the presence or absence of a documented diagnosis of constipation. Treatment decisions should be based on thorough examination and individualized patient needs. Furthermore, there is a need to increase monitoring for drug effectiveness.     

探讨神经内科护理安全隐患与措施

目的探讨神经内科护理中存在的安全隐患与相应措施。方法选取我院2009年5月至2010年3月住院神经内科患者80例,将其分为两组,对照组40例延用常规护理,观察组40例在对照组护理基础上附加相应护理措施,并对观察组20名护士进行清晨护理查房带教及相关教育,分析影响神经内科患者的危险因素,比较两组患者的满意度和护士病情知晓率。结果观察组患者满意度为97.5%,护士病情知晓率为95%;对照组患者满意度为87.5%,护士病情知晓率为80.0%,P〈0.05,差异具有统计学意义。结论神经内科护理中的安全隐患因素较多,我们要加强对护士临床知识的提高,突出重点全面护理,采取针对性护理措施降低安全事故的发生率,提高患者的满意度。     

认知行为疗法对功能性便秘患者临床症状的影响

目的 探讨认知行为疗法对功能性便秘(FC)患者心理状态和临床症状的影响.方法 对符合罗马ⅢFC诊断标准的78例患者随机分为两组.对照组(38例)给予促胃肠动力药物治疗,试验组(40例)在药物治疗的基础上给予认知行为疗法.两组疗程均为4周.于入组时、4周末采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对两组患者进行心理状态评定并比较临床症状改善情况和不良反应.结果4周末试验组SAS和SDS评分比入组时均显著降低[分别为(36.25±8.61)分比(42.97±9.25)分,P<0.01;(38.81±6.53)分比(43.36±7.18)分,P<0.01 .治疗后试验组与对照组SAS和SDS评分分别为(36.25±8.61)分和(41.31±6.09)分,P<0.01;(38.81±6.53)分和(42.33±7.64)分,P<0.05.试验组患者的有效率为97.50%(39/40),对照组患者的有效率为84.21%(32/38).两组比较差异有统计学意义(P<0.05).对照组的腹痛、腹泻及停药后复发分别为23.68%、15.79%、89.47%;试验组分别为5.00%、2.50%、5.00%,两组比较差异有统计学意义(P<0.05).结论 认知行为疗法有助于改善FC患者的心理状态,缓解便秘症状,减少不良反应的发生,优于单纯服用促胃肠动力药物治疗.     

Gastrointestinal symptoms predictors of health-related quality of life in pediatric patients with functional gastrointestinal disorders

Objectives

To investigate the patient-reported multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs).

Methods

The Pediatric Quality of Life Inventory? (PedsQL?) Gastrointestinal Symptoms Scales and PedsQL? 4.0 Generic Core Scales were completed in a 9-site study by 259 pediatric patients with functional constipation, functional abdominal pain (FAP), or irritable bowel syndrome (IBS). Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL.

Results

Gastrointestinal symptoms were differentially associated with decreased HRQOL in bivariate analyses for the three FGIDs. In predictive models utilizing hierarchical multiple regression analyses controlling for age, gender, and race/ethnicity, gastrointestinal symptoms differentially accounted for an additional 47, 40, and 60 % of the variance in patient-reported HRQOL for functional constipation, FAP, and IBS, respectively, reflecting large effect sizes. Significant individual gastrointestinal symptoms predictors were identified after controlling for the other gastrointestinal symptoms in the FGID-specific predictive models.

Conclusions

Gastrointestinal symptoms represent potentially modifiable predictors of generic HRQOL in pediatric patients with FGIDs. Identifying the condition-specific gastrointestinal symptoms that are the most important predictors from the patient perspective facilitates a patient-centered approach to targeted interventions designed to ameliorate impaired overall HRQOL.

     

妇科门诊女性尿失禁患病率及危险因素调查

目的对广州市妇婴医院妇科门诊女性进行尿失禁的问卷调查,了解妇科门诊女性尿失禁患病现状。并对可能的危险因素进行调查,探索尿失禁可能的影响因素。方法对2004年1月~2005年1月因非尿失禁因素就诊于广州市妇婴医院妇科门诊年满18岁的妇女进行尿失禁问卷调查。受调查总人数为2000例。结果①妇科门诊女性尿失禁患病率为29.4%。②随年龄增加女性尿失禁的患病率也随之增加。③BMI、孕次、产次、不同的分娩方式、习惯性便秘、文化程度与尿失禁有关(χ2=23.675,P<0.01;χ2=29.437,P<0.01;χ2=42.592,P<0.01;χ2=3.897,P<0.05;χ2=3.837,P=0.05;χ2=9.276,P<0.01)。④不同职业、居住环境、收入尿失禁患病率相近,χ2分别为0.115,0.548,0.230,P>0.05。⑤Logistic逐步回归分析中协变量年龄、BMI、产次、泌尿系疾病、便秘和职业的OR值均大于1。结论妇科门诊成年女性尿失禁患病率为29.4%。随着年龄的上升,尿失禁患病率总体呈上升趋势。单因素分析显示年龄、BMI、孕产次、分娩方式、某些慢性病、文化程度为尿失禁危险因素,收入、居住环境、职业与尿失禁无关。单因素分析结合Logistic逐步回归分析提示尿失禁是多因素综合的结果。