精益化管理对老年股骨颈骨折患者术后长期卧床致便秘的影响

Effects of lean management on postoperative long-term bed rest-induced constipation in elderly patients with femoral neck fractures

中文关键词: 老年  股骨颈骨折  精益化管理  手术  长期卧床  便秘

英文关键词: elderly  femoral neck fractures  lean management  surgery  long-term bed rest  constipation

中文摘要:

      目的 探讨精益化管理对老年股骨颈骨折(FNF)患者术后长期卧床致便秘的影响.方法 选取2021 年4 月—2022 年4 月于空军军医大学第二附属医院进行治疗的老年FNF患者90 例,按照随机信封法分为2 组:精益组(n =45)和常规组(n =45).2 组均进行类似的术式和相同术后治疗之外,精益组患者给予基于精益化管理的护理干预,常规组患者给予常规管理的护理干预.观察并比较2 组术后指标、首次大便通畅度、焦虑情况、首次排便粪便形状、术后14d排便情况及服用辅助药物排便患者比例.结果 干预14 d,精益组术后自觉肠鸣音时间、肛门排气时间及首次排便时间均少于常规组(P＜0.05);精益组首次大便通畅度评分、焦虑自评量表评分皆低于常规组(P＜0.05);精益组首次排便粪便形状分级高于常规组(P＜0.05),且便秘发生率低于常规组(P＜0.05);精益组Wexner便秘评分系统得分低于常规组(P＜0.05);精益组辅助药物排便患者比例低于常规组(6.67%vs 24.44%)(P＜0.05).结论 精益化管理可能预防老年FNF患者术后长期卧床导致的便秘,改善大便通畅度,促进其术后恢复自主排便,具有一定的临床应用价值.

英文摘要:

      Objective To explore the effects of lean management on postoperative long-term bed rest-induced constipa-tion in elderly patients with femoral neck fractures(FNF).Methods 90 elderly FNF patients treated in Second Affiliated Hos-pital of Air Force Medical University from April 2021 to April 2022 were selected and divided into two groups according to ran-dom envelope method:lean group(n =45)and conventional group(n =45).Both groups underwent similar surgical proce-dures and the same postoperative treatment.In addition,patients in the lean group received nursing interventions based on lean management,while patients in the conventional group received nursing interventions based on conventional management.Post-operative indicators,first defecation patency,anxiety,shape of first stool,defecation at 14 days after surgery and the propor-tion of patients taking adjuvant drugs for defecation were observed and compared between the two groups.Results After 14 days of intervention,the postoperative conscious bowel sound time,anal exhaust time and first defecation time of the lean group were shorter than those of the conventional group(P＜0.05).The scores of first defecation patency and Self-Rating Anxiety Scale of the lean group were lower than those of the conventional group(P＜0.05).The grading of first stool shape of the lean group was higher than that of the conventional group(P＜0.05),and the incidence of constipation was lower than that of the conventional group(P＜0.05).The score of Wexner constipation scoring system of the lean group was lower than that of the conventional group(P＜0.05).The proportion of patients taking adjuvant drugs for defecation in the lean group was lower than that in the conventional group(6.67%vs24.44%)(P＜0.05).Conclusion Lean management may prevent postopera-tive long-term bed rest-induced constipation in elderly FNF patients,improve defecation patency,and promote the recovery of autonomous defecation after surgery,which has certain clinical application value.