护理干预在预防强阿片类药物致便秘中的疗效.docVIP

护理干预在预防强阿片类药物致便秘中的疗效 　　doi：10.3969/j.issn.1007-614x.2014.22.84 　　摘要目的：探讨护理干预对预防由阿片类药物引起便秘的疗效。方法：2013年9月-2013年12月收治癌痛患者30例，均为首次服用阿片类药物，作为对照组。2013年9月-2014年3月收治癌痛患者30例，均为首次服用阿片类药物，作为试验组。试验组进行药物干预、饮食、运动等护理措施预防便秘，对照组给予常规治疗护理。结果：护理干预使试验组便秘程度明显低于对照组，可有效改善服用阿片类药物引起的便秘。结论：患者开始口服阿片类药物时，就应开始护理干预预防便秘，阿片类药物引起的便秘预防应贯穿于治疗的整个过程。 　　关键词阿片类药物；便秘；护理干预；肠功能量表 　　The effect of nursing intervention in the prevention of strong opioid induced constipation 　　Guo Jing，Gu Xiaolian 　　East Area of Suzhou municipal hospital Affiliated to Nanjing Medical University（Suzhou City，Jiangsu），215001 　　AbstractObjective：To explore the effect of nursing intervention in the prevention of opioid induced constipation.Methods： 30 cases with cancer pain were selected from September 2013 to December 2013， who took opioids for the first time， as the control group.30 cases with cancer pain were selected from September 2013 to March 2014， who took opioids for the first time， as intervention group.The intervention group were given nursing intervention to prevent constipation，such as medicine intervention， diet，exercise and so on.The control group were given routine treatment nursing.Results：Nursing intervention made the degree of constipation in the experimental group significantly lower than that of the control group.Nursing intervention could effectively improve the use of opioid induced constipation.Conclusion：When patients begin to oral opioid drugs， nursing intervention should be started to prevent constipation.The prevention of opioid induced constipation should be run through the whole process of treatment. 　　Key wordsOpioid；Constipation；Nursing intervention；Bowel function scale 　　据WHO统计，30%～50%癌症患者伴有不同程度的疼痛。我国现有癌症患者200多万，每年新发病例约160万，疼痛发生率40%～50%，50%患者的疼痛为中至重度；在接受癌症治疗的患者中，50%有疼痛感，70%以疼痛为主要症状[1]，在晚期癌症患者中疼痛则达到90%[2]。癌性疼痛患者可能生存数月或数年，如果疼痛得不到恰当的治疗，他们将长期忍受疼痛的折磨，对患者和家属的生活质量造成及其严重的影响。在2011我国启动了“癌痛规范化治疗示范病房”创建活动，我科响应国家及卫生厅的号召，于2013年挂牌了省级“癌症无痛示范病房”，旨在提高肿瘤患者生存质量。镇痛药物主要为阿片类，与胃肠神经丛分泌腺体结合，抑制肠蠕动并使肠道腺体分泌减少，使肠道挪动减慢