摘要
背景混合痔术后便秘是常见且影响患者生活质量的并发症,常规的术后护理措施往往无法有效缓解这一问题.多学科协作的多元素干预措施通过围手术期的饮食指导、药物干预及家属参与,能综合改善患者的术后恢复情况.本研究假设,实施多学科协作干预能够显著缩短便秘患者术后恢复时间、降低并发症发生率、提高患者的生活质量与满意度,为临床护理提供新思路.目的探讨基于多学科协作的多元素干预措施在混合痔术后便秘患者中的应用效果.方法选取2024-01/2024-12在瑞安市人民医院接受混合痔手术治疗的111例便秘患者,随机分为观察组(n=62)和对照组(n=49).对照组接受常规术后便秘防治措施,包括术后常规指导及对症通便治疗.观察组在对照组基础上,实施多学科协作的多元素干预措施,包括围手术期超前饮食干预、指导家属合理饮食搭配、术后排便药物干预等.比较两组患者的一般临床资料、术后临床症状恢复情况、便秘症状评分(Constipation Symptom Score,CSS)、简明健康状况调查问卷36条评分(Short Form 36 Health Survey,SF-36)评估生活质量、术后并发症发生情况及治疗满意度.结果与对照组相比,观察组患者首次排便时间、疼痛消失时间、出血消失时间、水肿消失时间及创面愈合时间均显著缩短(P<0.05);干预后及术后三个月CSS评分显著降低(P<0.05);干预后及术后三个月SF-36评分显著提高(P<0.05);术后出血、感染和便秘发生率显著降低(P<0.05);治疗总满意度显著提高(P<0.05).结论基于多学科协作的多元素干预能有效改善混合痔术后便秘患者的临床症状、提高生活质量、降低并发症发生率,并提升患者满意度,值得临床推广应用.
BACKGROUND Postoperative constipation after mixed hemorrhoid surgery is a common and significant complication that affects patients’quality of life.Conventional postoperative care measures often fail to effectively alleviate this problem.Multidisciplinary collaborative multi-component intervention measures,including perioperative dietary guidance,drug intervention,and family participation,can comprehensively improve the postoperative recovery of patients.This study hypothesized that implementing multidisciplinary collaborative intervention can significantly shorten the postoperative recovery time in patients with constipation,reduce the incidence of complications,improve the quality of life and satisfaction of patients,and provide new ideas for clinical nursing.AIM To investigate the efficacy of multidisciplinary collaborative multi-component intervention in patients experiencing constipation after mixed hemorrhoidectomy.METHODS A total of 111 patients who underwent mixed hemorrhoidec-tomy at our hospital from January 2024 to December 2024 and developed postoperative constipation were randomly assigned to an observation group(n=62)and a control group(n=49).Both groups received conventional postoperative constipation management,including standard postoperative guidance and symptomatic laxative treatment.The observation group additionally received multidisciplinary collaborative multi-component intervention,which included proactive dietary intervention during the perioperative period,guidance for family members on appropriate dietary combinations,and postoperative bowel movement medication intervention.General clinical data,postoperative clinical symptom recovery,Constipation Symptom Score(CSS),and Short Form 36 Health Survey(SF-36)scores,as well as the incidence of postoperative complications and treatment satisfaction,were compared between the two groups.RESULTS Compared to the control group,the time to first bowel move-ment,time to pain resolution,time to bleeding cessation,time to edema resolution,and time to wound healing were significantly shorter(P<0.05);CSS immediately after intervention and at three months post-surgery were signi-ficantly lower and SF-36 scores were significantly higher(P<0.05);the incidence rates of postoperative bleeding,infection,and constipation were significantly lower(P<0.05);and overall treatment satisfaction was significantly higher in the observation group(P<0.05).CONCLUSION Multidisciplinary collaborative multi-component intervention effectively improves clinical symptoms,enhances quality of life,reduces the incidence of complications,and increases patient satisfaction in patients with postoperative constipation following mixed hemorrhoidectomy.This approach warrants clinical promotion and application.
作者
戴鹏飞
曾达开
陈磊
詹蒙蒙
宋杰
宋猛
Peng-Fei Dai;Da-Ke Zeng;Lei Chen;Meng-Meng Zhan;Jie Song;Meng Song(Department of Colorectal Surgery,Rui’an People’s Hospital,Wenzhou 325200,Zhejiang Province,China)
出处
《世界华人消化杂志》
2025年第10期831-837,共7页
World Chinese Journal of Digestology
基金
瑞安市科技计划项目,No.MS2023008。
关键词
混合痔
便秘
多学科
多元素
干预
Mixed hemorrhoids
Constipation
Multidiscip-linary
Multi-component
Intervention
