造口灌洗和永久性结肠造口患者排便规律研究.docVIP

造口灌洗和永久性结肠造口患者排便规律研究 　　[摘要] 目的 探讨造口灌洗与永久性结肠造口患者排便规律的相关性。 方法 选取2011年5月~2013年1月韶关市铁路医院就诊的直肠癌根治术后永久性结肠造口患者65例为研究对象，按照随机数字表法将其分为观察组（32例）与对照组（33例）。采用自然排便法及常规护理方法对对照组患者进行治疗，观察组采用造口灌洗及干预护理方法。观察两组患者的排便时间是否固定、每日排便次数、排便前是否有便意、排便时是否有感觉等指标，研究造口灌洗与永久性结肠造口患者排便规律的相关性，并比较两组患者的生活质量评分（QOL评分）。 结果 观察组排便时间固定及每日排便次数为1~3次患者所占比例（71.88%、59.38%）明显高于对照组（33.33%、30.30%），差异有统计学意义（P ＜ 0.05）；观察组患者排便前有便意（78.13%）及排便时有感觉（68.75%）者所占比例高于对照组（51.52%、45.45%），差异有统计学意义（P ＜ 0.05）；观察组排便时间是否固定、每日排便次数、排便前是否有便意、排便时是否有感觉与排便规律相关（OR = 2.675、3.120、3.156、3.279，均P ＜ 0.05）。两组患者术后6个月QOL评分总分、躯体生理、日常和社会活动、精神状态与术后1个月比较，差异有统计学意义（P ＜ 0.05）；术后6个月观察组患者QOL评分总分[（115.32±12.36）分]、躯体生理[（18.76±2.71）分]、日常和社会活动[(15.37±2.21)分]、精神状态[(20.19±2.56)分]均显著高于对照组[(105.32±11.15)、(15.34±2.30)、(13.18±2.33)、(15.16±2.35)分]，差异有统计学意义（均P ＜ 0.05）。 结论 结肠造口灌洗法可使患者达到规律、自控排便，便于患者生活、社交、旅行等日常生活，恢复结肠造口患者的正常生活。 　　[关键词] 造口灌洗；永久性结肠造口；排便规律；相关性；生活质量 　　[中图分类号] R472[文献标识码] B[文章编号] 1673-7210（2014）05（b）-0122-04 　　 　　Study on colostomy lavage and defecation regularity of patients with permanent colostomy 　　LUO Sandi LUO Shaosheng LIAO Qinghua CHEN Lifang 　　Railway Hospital of Shaoguan City, Guangdong Province, Shaoguan 512023, China 　　[Abstract] Objective To explore the correlation between colostomy lavage and defecation regularity of patients with permanent colostomy. Methods 65 patients with permanent colostomy after rectal cancer surgery from May 2011 to January 2013 in Railway Hospital of Shaoguan City were selected as the study objects, and they were randomly divided into observation group (32 cases) and control group (33 cases). The control group were treated with natural defecation method and routine nursing, while the observation group were treated with colostomy lavage and nursing intervention methods. Patients whether or not have fixed defecate time, daily defecation frequency, whether or not have intention before defecation, whether or not have feeling during defecation in the two groups were observed. The correlation of colostomy lavage and defecati