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心脏手术患者出院后六周内胃肠道症状的发生率。

The incidence of gastrointestinal symptoms in cardiac surgery patients through six weeks after discharge.

作者信息

Grap M J, Savage L, Ball G B

机构信息

School of Nursing, Virginia Commonwealth University, Richmond, USA.

出版信息

Heart Lung. 1996 Nov-Dec;25(6):444-50. doi: 10.1016/s0147-9563(96)80045-8.

Abstract

OBJECTIVE

To determine the incidence and the effect of intraoperative and discharge variables on gastrointestinal (GI) symptoms after cardiac surgery during hospitalization and 2 and 6 weeks after discharge.

DESIGN

Prospective and descriptive.

SETTING

Two university-affiliated medical centers.

PATIENTS

One hundred twenty-two adult patients undergoing cardiac surgery.

OUTCOME MEASURES

Frequency of GI symptoms and level of distress caused by GI symptoms during hospitalization and 2 and 6 weeks after hospital discharge.

INSTRUMENTS

GI symptoms were measured by The Gastrointestinal Symptom Frequency and Symptom Distress Scale. Depression was measured by The Center for Epidemiologic Studies Depression Scale.

INTERVENTION

Demographic and physiologic variables were collected by chart review. Patients completed the Gastrointestinal Symptom Frequency and Symptom Distress Scale and The Center for Epidemiologic Studies Depression Scale in the hospital. Telephone interviews were used to collect 2- and 6-week data.

RESULTS

Fifty-seven percent of patients after surgery reported poor appetite, 37% lack of taste, and 34% nausea during hospitalization. The frequency of all GI symptoms decreased with time; 19% of subjects reported poor appetite, 19% lack of taste, and 10% nausea at 6 weeks after discharge. Although poor appetite occurred with the greatest frequency, patients reported the greatest distress with lack of taste. When analyzed with a logistic regression model, use of antihypertensive agents was associated with lack of taste; use of diuretic and antiarrhythmic agents was associated with nausea; and level of depression was associated with all three GI symptoms. Length of cardiopulmonary bypass time mean arterial blood pressure during surgery, mixed venous oxygen saturation during surgery, and subject age did not significantly affect the frequency of GI symptoms at any data collection point.

CONCLUSIONS

The incidence of GI symptoms after cardiac surgery is significant, but their etiology has yet to be determined.

摘要

目的

确定心脏手术后住院期间以及出院后2周和6周时,术中及出院相关变量对胃肠道(GI)症状的发生率及影响。

设计

前瞻性描述性研究。

地点

两家大学附属医院。

患者

122例接受心脏手术的成年患者。

观察指标

住院期间以及出院后2周和6周时胃肠道症状的发生频率以及胃肠道症状所致的痛苦程度。

工具

采用胃肠道症状频率和症状痛苦量表测量胃肠道症状。采用流行病学研究中心抑郁量表测量抑郁情况。

干预措施

通过查阅病历收集人口统计学和生理学变量。患者在医院完成胃肠道症状频率和症状痛苦量表以及流行病学研究中心抑郁量表的填写。通过电话访谈收集2周和6周的数据。

结果

术后57%的患者在住院期间报告有食欲减退,37%报告味觉缺失,34%报告恶心。所有胃肠道症状的发生频率均随时间下降;出院6周时,19%的受试者报告有食欲减退,19%报告味觉缺失,10%报告恶心。尽管食欲减退的发生率最高,但患者报告味觉缺失时的痛苦程度最大。经逻辑回归模型分析,使用抗高血压药物与味觉缺失有关;使用利尿剂和抗心律失常药物与恶心有关;抑郁程度与所有三种胃肠道症状有关。体外循环时间、手术期间平均动脉血压、手术期间混合静脉血氧饱和度以及患者年龄在任何数据收集点均未显著影响胃肠道症状的发生频率。

结论

心脏手术后胃肠道症状的发生率较高,但其病因尚未明确。

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