Yabunaka Koichi, Nakagami Gojiro, Tabata Keiko, Sugama Junko, Matsumoto Masaru, Kido Yoshifumi, Iuchi Terumi, Sanada Hiromi
Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo.
Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo.
Drug Discov Ther. 2018;12(4):233-238. doi: 10.5582/ddt.2018.01033.
This study aims to assess the fecal retention in elderly patients using colonic ultrasonography (US) in Japanese long-term care facility and determine the correlation between nutrition management methods and the fecal retention by US. This cross-sectional, single-center study was conducted in a long-term care facility in Japan. Patients with chronic constipation fulfilled the Rome III criteria for the diagnosis of functional constipation. US was performed on constipation patients with 4-day fecal retention before starting the standard management of constipation. After patients had defecated, nurses checked the outside of feces using King's Stool Chart and Bristol Stool Chart. All of 32 patients underwent the management of suppository laxative, the daily life independence level in grade C. In all cases, the King's Stool Chart did not detect > 200 g of fecal matter; the Bristol Stool Chart revealed type 5-7 in 56.2% of patients. The total parenteral nutrition and tube feeding did not completely detect type 1-2 in 0%. While the fecal retention groups comprised 15.6%, the non-fecal retention groups comprised 84.4%. The total parenteral nutrition did not completely detect the fecal retention in 0%. In the non-fecal retention groups, the King's Stool Chart indicated < 100 g in 81.8%, and the Bristol Stool Chart indicated type 5-7 in 100%. In conclusion, fecal properties of elderly constipation patients with the long-term parenteral nutrition should be assessed in follow-up examination by US, which is possible for personalized medical care by US, to avoid the administered regular management of constipation.
本研究旨在通过结肠超声检查(US)评估日本长期护理机构中老年患者的粪便潴留情况,并确定营养管理方法与经超声检查的粪便潴留之间的相关性。这项横断面单中心研究在日本的一家长期护理机构中进行。符合慢性便秘的患者满足罗马III功能性便秘诊断标准。在开始便秘标准管理前,对有4天粪便潴留的便秘患者进行超声检查。患者排便后,护士使用金氏粪便图表和布里斯托粪便图表检查粪便外观。32例患者均接受了栓剂泻药治疗,日常生活自理能力为C级。在所有病例中,金氏粪便图表未检测到超过200克的粪便物质;布里斯托粪便图表显示56.2%的患者为5-7型。全胃肠外营养和管饲在0%的患者中未完全检测到1-2型。粪便潴留组占15.6%,非粪便潴留组占84.4%。全胃肠外营养在0%的患者中未完全检测到粪便潴留。在非粪便潴留组中,金氏粪便图表显示81.8%的患者粪便重量<100克,布里斯托粪便图表显示100%的患者为5-7型。总之,长期接受肠外营养的老年便秘患者的粪便特性应在后续检查中通过超声进行评估,这使得通过超声进行个性化医疗护理成为可能,以避免常规便秘管理。