心血管手术患者术后便秘的影响因素分析:一项横断面前瞻性研究

Ping Zhang, Chun Liu, Wen Qi, Xiaoli Xie, Yunyan Su
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引用次数: 0

摘要

背景:本研究旨在评估心血管手术患者术后便秘的潜在影响因素。研究方法本研究纳入了在南京鼓楼医院接受心血管手术的 379 例患者。根据是否存在术后便秘将患者分为两组。利用逻辑回归分析进行单变量和多变量分析,以阐明影响排便问题的因素。随后,通过接收器操作特征曲线(ROC)对研究结果的预测准确性进行了评估。结果在 379 名心血管手术患者中,有 20.8%(n = 79)的患者报告了术后排便问题。多变量逻辑回归分析显示,年龄(比值比 (OR) = 1.063,95% 置信区间 (CI) 1.034-1.097,p < 0.001)、手术时间(OR = 1.004,95% CI:1.000-1.008,p = 0.028)、呼吸机使用时间(OR = 1.032,95% CI:1.010-1.055,p = 0.004)、多种药物(OR = 2.134,95% CI:1.069-4.321,p = 0.032)、使用止咳药(OR = 2.981,95% CI:1.271-6.942,p = 0.011)和医院环境中排便的心理或行为障碍(OR = 31.039,95% CI:14.313-73.179,p < 0.001)是心血管手术患者术后便秘的独立危险因素。预测术后便秘的曲线下面积(AUC)为 0.885。结论为了优化术后恢复并降低术后便秘发生率,必须采取有针对性的方法。具体来说,针对老年患者、手术时间过长和呼吸机使用时间过长的患者、使用多种药物治疗的患者、使用止咳药的患者以及在医院环境中排便存在心理或行为障碍的患者采取重点干预措施至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of the Influencing Factors of Postoperative Constipation in Patients Undergoing Cardiovascular Surgery: A Cross-Sectional and Prospective Study
Background: The aim of this study was to estimate the potential influencing factors of postoperative constipation in patients undergoing cardiovascular surgery. Methods: This study included a cohort of 379 patients who underwent cardiovascular surgery at Nanjing Drum Tower Hospital. The patient cohort was stratified into two groups based on the presence or absence of postoperative constipation. Utilizing logistic regression analysis, both univariate and multivariate analyses were conducted to elucidate the factors influencing defecation problems. The predictive accuracy of the findings was subsequently evaluated through the receiver operating characteristic (ROC) curve. Results: Among the cohort of 379 patients subjected to cardiovascular surgery, a noteworthy 20.8% (n = 79) reported incidences of postoperative defecation issues. A multivariate logistic regression analysis showed that age (odds ratio (OR) = 1.063, 95% confidence interval (CI) 1.034–1.097, p < 0.001), operation time (OR = 1.004, 95% CI: 1.000–1.008, p = 0.028), ventilator usage time (OR = 1.032, 95% CI: 1.010–1.055, p = 0.004), polypharmacy (OR = 2.134, 95% CI: 1.069–4.321, p = 0.032), use of cough medicine (OR = 2.981, 95% CI: 1.271–6.942, p = 0.011) and psychological or behavioral barriers to defecation in the hospital environment (OR = 31.039, 95% CI: 14.313–73.179, p < 0.001) were independent risk factors for postoperative constipation in patients undergoing cardiovascular surgery. The area under the curve (AUC) for predicting postoperative constipation was 0.885. Conclusion: In the pursuit of optimizing postoperative recovery and mitigating postoperative constipation incidence, a targeted approach is imperative. Specifically, a focused intervention directed towards elderly patients, extended operation and prolonged ventilator durations, polypharmacy regimens, use of cough medicine, and those with psychological or behavioral barriers to defecation within the hospital milieu emerges as pivotal.
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