结肠造口灌洗:25例患者的结果,特别提及生活质量

Colostomy irrigation: results of 25 cases with particular reference to quality of life.

作者信息

Karadağ Ayişe, Menteş B Bülent, Ayaz Sultan

机构信息

Gazi University School of Nursing, Ankara, Turkey.

出版信息

J Clin Nurs. 2005 Apr;14(4):479-85. doi: 10.1111/j.1365-2702.2004.01083.x.

Abstract

AIMS AND OBJECTIVES

The aim of this study was to document our results with colostomy irrigation with particular emphasis on the possible contribution of irrigation on quality of life.

BACKGROUND

Colostomy irrigation is a useful method of achieving faecal continence in selected conditions, and may improve quality of life. When successful, irrigation offers a regular, predictable elimination pattern and only a small covering is needed for security between irrigations.

METHODS

The digestive disease quality of life questionnaire-15 (DDQ-15) and Short Form-36 were used to analyse quality of life before and 12 months after stomatherapy in a series of 25 irrigating patients with permanent end colostomies. During the same time period, 10 similar patients with left-end colostomies who also received counselling but did not consent to colostomy irrigation were also analysed for comparison.

RESULTS

Colostomy irrigation was found to be effective for achieving faecal continence in selected patients with end colostomies with no complications or significant side-effects, The digestive disease quality of life questionnaire-15 score improved significantly in both groups after stomatherapy (P < 0.0001 and P = 0.009 in the irrigating and non-irrigating groups respectively). The poststomatherapy digestive disease quality of life questionnaire-15 score of the irrigating group was also significantly higher than that of the non-irrigating group (P = 0.039). Although none of the poststomatherapy item scales of Short Form-36 differed significantly between the two groups, stomatherapy with CI resulted in significant improvements in role limitation due to physical problems, social functioning, role limitation due to emotional problems, general mental health, vitality and bodily pain (P < 0.05 for all comparisons). On the contrary, the non-irrigating patient group showed significant improvements only in social functioning and general mental health.

CONCLUSION

Our findings suggest that colostomy irrigation can be a useful method of achieving faecal continence in selected conditions, it is safe, and it may help improve many aspects of quality of life.

RELEVANCE TO CLINICAL PRACTICE

Colostomy irrigation is free from complications and significant side-effects, and it may serve as a useful adjunct to conventional stomatherapy. Therefore, the enterostomal therapy nurse should assess the appropriateness of routine irrigation as a method of stoma management for patients with left-end colostomy.

摘要

目的与目标

本研究旨在记录我们在结肠造口灌洗方面的结果,特别强调灌洗对生活质量可能产生的影响。

背景

结肠造口灌洗是在特定情况下实现粪便节制的一种有用方法,并且可能改善生活质量。成功进行灌洗时,排便规律可预测,两次灌洗之间只需很小的覆盖物来保障安全。

方法

使用消化系统疾病生活质量问卷15(DDQ - 15)和简明健康状况调查问卷(Short Form - 36),对25例接受结肠造口灌洗的永久性末端结肠造口患者在造口治疗前和治疗12个月后的生活质量进行分析。在同一时期,还对10例类似的左半结肠造口患者进行了分析,这些患者也接受了咨询,但未同意进行结肠造口灌洗,以作比较。

结果

发现结肠造口灌洗对于选定的末端结肠造口患者实现粪便节制有效,且无并发症或明显副作用。造口治疗后,两组的消化系统疾病生活质量问卷15评分均显著改善(灌洗组和非灌洗组分别为P < 0.0001和P = 0.009)。灌洗组造口治疗后的消化系统疾病生活质量问卷15评分也显著高于非灌洗组(P = 0.039)。虽然简明健康状况调查问卷36的造口治疗后各项量表在两组之间均无显著差异,但结肠造口灌洗造口治疗在因身体问题导致的角色受限、社会功能、因情绪问题导致的角色受限、总体心理健康、活力和身体疼痛方面有显著改善(所有比较P < 0.05)。相反,非灌洗患者组仅在社会功能和总体心理健康方面有显著改善。

结论

我们的研究结果表明,结肠造口灌洗在特定情况下可能是实现粪便节制的一种有用方法,它是安全的,并且可能有助于改善生活质量的多个方面。

与临床实践的相关性

结肠造口灌洗无并发症和明显副作用,可作为传统造口治疗的有益辅助手段。因此,造口治疗护士应评估常规灌洗作为左半结肠造口患者造口管理方法的适用性。

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