Gonzales Lucia K, Delmastro Margaret A, Boyd Denise M, Sterling Melvyn L, Aube Patricia A, Le Rosemary N, Traucht Lisa, Quinal Leonida R, Georges Jane M, Glaser Dale N
Hahn School of Nursing and Health Science, Betty and Bob Beyster Institute for Nursing Research, Advanced Practice and Simulation, University of San Diego, San Diego, CA, USA
Palliative Care Team, St Joseph Hospital, Orange, CA, USA.
Am J Hosp Palliat Care. 2016 Aug;33(7):663-8. doi: 10.1177/1049909115584754. Epub 2015 May 11.
In palliative medicine, constipation is the third most common symptom after pain and anorexia, causing some patients to discontinue opioid therapy. Women experience higher incidence of constipation than men. The prevalence of infrequent bowel movements (<3 times/wk) and adherence to an established bowel regimen among women receiving opioids were studied. Referral to the palliative care team decreased the prevalence of infrequent bowel movements from 72% to 45%, and algorithm adherence increased from 38% to 78%. Education of oncology nurses decreased the prevalence of infrequent bowel movements among patients with cancer from 71% to 60%, and algorithm adherence increased from 0% to 10%. Patients benefit from stool softeners and stimulants when receiving opioids.
在姑息医学中,便秘是仅次于疼痛和厌食的第三大常见症状,这导致一些患者停止使用阿片类药物治疗。女性便秘的发生率高于男性。研究了接受阿片类药物治疗的女性中排便次数少(<3次/周)的患病率以及对既定肠道护理方案的依从性。转诊至姑息治疗团队使排便次数少的患病率从72%降至45%,方案依从性从38%提高到78%。对肿瘤护理人员的培训使癌症患者中排便次数少的患病率从71%降至60%,方案依从性从0%提高到10%。患者在接受阿片类药物治疗时可从软化剂和刺激性泻药中获益。