Department of Orthopedic Surgery, Luoyang Orthopedic Hospital of Henan Province. Orthopedic Hospital of Henan Province, Luoyang, China.
Zhejiang Chinese medical university, Hangzhou, China.
J Clin Nurs. 2020 Aug;29(15-16):2863-2871. doi: 10.1111/jocn.15299. Epub 2020 May 26.
To evaluate the efficacy and safety of a comprehensive protocol for constipation prevention.
Constipation is a common problem for patients undergoing total hip arthroplasty (THA), yet sparse evidence is available to guide constipation prevention after THA.
Randomised controlled superiority clinical trial.
This randomised controlled study was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). A total of 80 THA patients were randomised to receive only preoperative education about lifestyle or the combination of education with postoperative abdominal massage and polyethylene glycol 4,000 (Forlax®). Efficacy outcomes included rates of postoperative constipation and enema rescue, as well as time to first postoperative defecation and readmission within 30 days. Safety outcomes were number and type of adverse events.
Patients who received combination treatment showed a significantly lower rate of postoperative constipation during hospitalisation than patients who received only preoperative education (25% versus 55%), and they showed a significantly lower rate of enema rescue (12.5% versus 40%). Many more patients receiving combination treatment experienced their first defecation within two postoperative days than patients who received only preoperative education (62.5% versus 35.9%). In contrast, the two groups were similar in terms of constipation rate on postoperative days 15 and 30, rate of readmission within 30 days and rate of postoperative adverse events.
These results suggest that our comprehensive protocol can relieve constipation after THA, reduce the need for enema rescue and shorten time to first defecation without sacrificing safety. More work is needed to optimise and develop this protocol further.
Constipation is a distressing problem that frequently occurs after THA. This study confirmed that a comprehensive protocol including preoperative education, postoperative abdominal massage and polyethylene glycol 4,000 can effectively relieve constipation after THA without sacrificing safety.
评估综合预防便秘方案的疗效和安全性。
便秘是全髋关节置换术（THA）患者的常见问题，但指导 THA 后预防便秘的证据很少。
随机对照优势临床试验。
这项随机对照研究是按照 CONSORT 报告标准进行的。将 80 例 THA 患者随机分为仅接受术前生活方式教育或教育联合术后腹部按摩和聚乙二醇 4000（Forlax®）治疗组。疗效结局包括术后便秘和灌肠解救的发生率，以及首次术后排便时间和 30 天内再入院率。安全性结局为不良事件的数量和类型。
接受联合治疗的患者在住院期间的术后便秘发生率明显低于仅接受术前教育的患者（25%比 55%），并且接受灌肠解救的患者明显减少（12.5%比 40%）。接受联合治疗的患者中有更多的人在术后两天内首次排便（62.5%比 35.9%）。相比之下，两组在术后第 15 天和第 30 天的便秘发生率、30 天内再入院率和术后不良事件发生率方面无显著差异。
这些结果表明，我们的综合方案可以缓解 THA 后的便秘，减少灌肠解救的需要，并缩短首次排便时间，而不影响安全性。需要进一步优化和开发该方案。
便秘是 THA 后常发生的一种令人痛苦的问题。本研究证实，包括术前教育、术后腹部按摩和聚乙二醇 4000 在内的综合方案可以有效缓解 THA 后的便秘，而不影响安全性。
