Department of Surgery, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Chung-Ang University H.C.S. Hyundae General Hospital, Namyangju, Korea.
Clin Orthop Surg. 2023 Aug;15(4):546-551. doi: 10.4055/cios22091. Epub 2023 Feb 13.
This prospective randomized controlled study aimed to determine the effects of abdominal massage on constipation management in elderly patients with hip fractures.
From August 2017 to December 2018, patients aged above 65 years with hip fractures (n = 88) were randomly assigned to a massage group that received a bowel massage (n = 48) or a control group that did not receive a bowel massage (n = 40). Patients in the bowel massage group received a bowel massage from a trained caregiver after breakfast at approximately 9:00 AM for an hour. On admission, 5 days after surgery, and on the day of discharge, the patient's normal and actual defecation pattern, stool consistency, and any problems with defecation were assessed through a structured interview. The questionnaire comprising the Bristol Stool Scale, patient assessment of constipation, time to defecation, medication for defecations, failure to defecate, cause of admission, admission period, and date of surgery were recorded. Statistical analyses were performed 5 days after surgery and on the day of discharge.
The mean age of the study cohort was 81.4 years (range, 65-99 years). The number of constipation remedies was significantly lower in the massage group than in the control group on postoperative day (POD) 5 and at discharge (9 vs. 15, = 0.049 and 6 vs. 11, = 0.039, respectively). The number of defecation failures was significantly lower in the massage group than in the control group (10 vs. 17, = 0.028) on POD 5. However, the number of defecation failures at discharge was not significantly different between the two groups ( = 0.131). The development of postoperative ileus ( = 0.271) and length of hospital stay ( = 0.576) were not different between the groups.
The number of constipation remedies was significantly lower in the massage group than in the control group on POD 5 and discharge, and the number of defecation failures was significantly lower in the massage group than in the control group on POD 5. Therefore, abdominal massage may be considered as an independent nursing initiative for constipation management.
本前瞻性随机对照研究旨在探讨腹部按摩对老年髋部骨折患者便秘管理的影响。
2017 年 8 月至 2018 年 12 月，我们纳入了 88 例年龄在 65 岁以上的髋部骨折患者（n=88），并将他们随机分配至按摩组（n=48）或对照组（n=40）。按摩组的患者在早餐后（约 9:00 AM）由经过培训的护理人员进行 1 小时的肠道按摩。在入院时、术后 5 天和出院当天，通过结构化访谈评估患者的正常和实际排便模式、粪便稠度以及排便困难等问题。记录了包括布里斯托粪便量表、患者便秘评估、排便时间、通便药物使用、排便失败、入院原因、入院时间和手术日期在内的问卷。在术后 5 天和出院当天进行了统计学分析。
研究队列的平均年龄为 81.4 岁（范围：65-99 岁）。与对照组相比，按摩组术后第 5 天（POD5）和出院时的便秘治疗药物数量明显减少（9 次比 15 次，=0.049；6 次比 11 次，=0.039）。按摩组的排便失败次数也明显少于对照组（POD5：10 次比 17 次，=0.028）。但两组在出院时的排便失败次数无明显差异（=0.131）。术后肠梗阻（=0.271）和住院时间（=0.576）在两组之间无差异。
与对照组相比，按摩组在 POD5 和出院时的便秘治疗药物数量明显减少，且在 POD5 时排便失败的次数也明显减少。因此，腹部按摩可以作为一种独立的护理措施用于便秘管理。
