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目的探讨开塞露联合生理盐水灌肠对晚期恶性肿瘤患者阿片类药物相关便秘的干预效果。方法选取2012年3月至2013年12月间湘潭县人民医院收治的300例晚期恶性肿瘤并长期使用阿片类药物镇痛出现便秘的患者,采用随机数字表法分为观察组与对照组,每组150例。观察组患者采用开塞露联合生理盐水灌肠治疗,对照组患者采用肥皂水灌肠治疗。对所有患者辅以饮食、按摩及心理干预,观察两种灌肠方法的治疗效果及干预后的生活质量。结果观察组患者总有效率为100.0%,明显高于对照组的89.3%,差异有统计学意义(P<0.05);干预前两组患者功能量表、症状量表及总体生活质量评分无显著差异(P>0.05),干预后两组患者均较干预前有明显改善,且观察组各项改善情况均优于对照组,两组比较,差异均有统计学意义(均P<0.05)。观察组不良反应率为20.0%,明显低于对照组32.7%,两组比较,差异有统计学意义(P<0.05)。结论开塞露联合生理盐水灌肠对晚期恶性肿瘤患者阿片类药物相关便秘进行干预,能改善便秘情况和生活质量,不良反应少,值得推广应用。
Objective To investigate the effect of Kaixailu combined with saline enema on opioid-related constipation in patients with advanced malignant tumors. Methods From March 2012 to December 2013, 300 patients with advanced malignant tumors admitted to Xiangtan People’s Hospital and long-term opioid analgesia patients with constipation were divided into observation group and control group by random number table Group of 150 cases. Patients in the observation group were treated with Kaixailu combined with saline enema, and patients in the control group were treated with soapy water enema. All patients were supplemented with diet, massage and psychological intervention to observe the therapeutic effect of two enemas and the quality of life after intervention. Results The total effective rate in the observation group was 100.0%, which was significantly higher than that in the control group (89.3%) (P <0.05). There was no significant difference in the functional scale, symptoms scale and overall quality of life before intervention (P> 0.05). After intervention, both groups improved significantly compared with those before intervention, and the improvements in the observation group were better than those in the control group. There was significant difference between the two groups (P <0.05). Adverse reaction rate was 20.0% in the observation group, which was significantly lower than that in the control group (32.7%). There was significant difference between the two groups (P <0.05). Conclusion Kaixailu combined with saline enema intervention for opioid-related constipation in patients with advanced malignant tumors can improve constipation and quality of life, with fewer adverse reactions, which is worth popularizing and applying.