在骨科创伤后的阿片类药物引起的便秘和相关症状
Gabriela Ortega1, Alexa Lisenby1, Tatiana Getz1
1Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
概括
在骨科创伤后,阿片类药物诱导的便秘很常见,影响疼痛和身体功能. 早期识别和干预对于改善患者的治疗结果至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 胃肠病学 胃肠病学
背景情况:
- 阿片类药物引起的便秘 (OIC) 是处方阿片类药物使用的常见不良影响.
- 整形外科患者通常接受阿片类药物处方,但OIC在这个人群中未得到充分研究.
- 了解OIC的表现对于管理骨科创伤后患者的康复至关重要.
研究的目的:
- 为了调查患者骨科损伤后OIC症状的频率.
- 分析OIC与患者报告的结果之间的关联,包括疼痛和身体功能.
- 确定对骨科患者OIC管理的潜在临床影响.
主要方法:
- 对86名接受了骨科创伤手术的临床试验参与者的数据进行了二次分析.
- 患者报告的结果在术后两周使用验证的问卷进行评估:患者报告的结果测量信息系统 (PROMIS) 对于疼痛干扰和身体功能,以及患者对便秘症状的评估 (PAC-SYM) 问卷.
- 使用线性回归模型来检查PAC-SYM得分与疼痛强度/PROMIS得分之间的关系,控制受伤严重程度和阿片类药物剂量.
主要成果:
- 显著的大多数参与者 (69%) 报告经历了OIC症状,7%经历了中度至严重的症状.
- 患有OIC症状的患者在PROMIS疼痛干扰 (3分) 和平均疼痛强度 (1.7分) 中呈现出统计学上显著的增加.
- 相反,患有OIC症状的参与者与没有OIC的参与者相比,PROMIS身体功能显著下降 (3分).
结论:
- 骨科创伤后OIC症状非常普遍,并与增加的疼痛干扰,增加的疼痛强度和减少的身体功能有关.
- 这些发现强调了需要在骨科手术患者中主动评估和管理OIC的需要.
- 实施护士主导的OIC评估可以促进及时干预,潜在地改善患者报告的整体伤害后结果.
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