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阿片类药物相关性便秘，一个令人烦恼且贯穿整个镇痛治疗的症状

2018-09-20 中护在线 中护在线订阅号

关注

健康教育-家属宣教指导家属及陪人了解OIC的病因、发病机制以及对患者的危害等，使其能正确面对患者的疼痛及可能出现的相关副作用和不良反应，提高家属及陪人对便秘的重视程度，减轻家属的担忧心理。心理护理使用强阿片类药物镇痛的患者多数已处于肿瘤的中晚期，体虚久卧床，加重便秘的发生。排便困难使其常伴有心理障碍又可加重便秘程度，而形成恶性循环，所以心理疏导是OIC患者护理干预的重要环节。饮食指导鼓励患者多摄入

健康教育-家属宣教

指导家属及陪人了解OIC的病因、发病机制以及对患者的危害等，使其能正确面对患者的疼痛及可能出现的相关副作用和不良反应，提高家属及陪人对便秘的重视程度，减轻家属的担忧心理。

心理护理

使用强阿片类药物镇痛的患者多数已处于肿瘤的中晚期，体虚久卧床，加重便秘的发生。排便困难使其常伴有心理障碍又可加重便秘程度，而形成恶性循环，所以心理疏导是OIC患者护理干预的重要环节。

饮食指导

鼓励患者多摄入富含维生素和膳食纤维的食物及水果，避免食用干硬、辛辣、刺激性食物，必要时可以将食物做成蔬菜粥以便食用。

生活护理

由于胃肠反射的作用，排便的最佳时间是饭后，鼓励患者养成每日定时排便的习惯，利用生理规律建立排便条件反射，可有利排便。

用药指导

为减轻便秘症状，尽量先从口服、小剂量开始。餐后30分钟是胃肠蠕动最强的时间，此时服用镇痛药物会影响胃肠蠕动，加重便秘，应指导患者避免饭后l小时内服用阿片类止痛药。

联合干预

鼓励患者适当增加运动量，运动可以增强体质、调整情绪、加快胃肠蠕动，促进粪便排出。

中医护理

可以采用足浴疗法，通过温水浸泡、搓洗和按摩，以达到清洁足部，改善血液循环，增强排泄功能。

定期随访

癌痛患者出院后，我们可以建立出院患者电子信息档案，责任护士应根据患者病情和治疗需要确定随访时间。

参考文献

1.  宫照玉. 阿片类药物致癌痛患者相关性便秘护理干预的研究进展[J]. 世界最新医学信息文摘， 2018，18(58)：70-71.

2.  ChristensenHN.Opioid-inducedconstipation， useoflaxa-tives， andhealth relatedqualityoflife[J].Scand J Pain，2016，11： 104-110.

3.  黄永英，程贤敏，文杨萍.护理干预对晚期癌痛患者阿片类便秘的影响[J].临床医学，2014，27(9)：262-263.

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    2019-08-13 shenxlcyp

    #相关性#

    0

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    2018-09-22 10518093zz

    #阿片类药物#

    0

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    2018-09-22 lhlxtx

    #阿片类#

    0

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    2018-09-22 zhaojie88

    #镇痛#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1837566, encodeId=5fb4183e566fa, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Tue Aug 13 06:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253071, encodeId=306012530e11c, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c83329, createdName=10518093zz, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309109, encodeId=1c251309109c3, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355290, encodeId=8ed01355290d5, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345992, encodeId=b866345992e6, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/9L7RSS4HNFbWiaCxQ9SMPJePqZcxoSkZ4YFzjfb8mcJqUxy3WsbFOMV2IoVFg2l7fAiaXAJcS7g7b2IIORVp1UKQ/132, createdBy=7e952039862, createdName=183****8264, createdTime=Fri Sep 21 09:52:44 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345913, encodeId=4a8c3459136c, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri Sep 21 00:02:43 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345910, encodeId=3d5c34591067, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu Sep 20 23:47:39 CST 2018, time=2018-09-20, status=1, ipAttribution=)]
    2018-09-21 183****8264

    学习了学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1837566, encodeId=5fb4183e566fa, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Tue Aug 13 06:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253071, encodeId=306012530e11c, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c83329, createdName=10518093zz, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309109, encodeId=1c251309109c3, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355290, encodeId=8ed01355290d5, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345992, encodeId=b866345992e6, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/9L7RSS4HNFbWiaCxQ9SMPJePqZcxoSkZ4YFzjfb8mcJqUxy3WsbFOMV2IoVFg2l7fAiaXAJcS7g7b2IIORVp1UKQ/132, createdBy=7e952039862, createdName=183****8264, createdTime=Fri Sep 21 09:52:44 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345913, encodeId=4a8c3459136c, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri Sep 21 00:02:43 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345910, encodeId=3d5c34591067, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu Sep 20 23:47:39 CST 2018, time=2018-09-20, status=1, ipAttribution=)]
    2018-09-21 1209e435m98(暂无昵称)

    学习了，谢谢分享

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1837566, encodeId=5fb4183e566fa, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Tue Aug 13 06:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253071, encodeId=306012530e11c, content=<a href='/topic/show?id=13159e8871d' target=_blank style='color:#2F92EE;'>#阿片类药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97887, encryptionId=13159e8871d, topicName=阿片类药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c83329, createdName=10518093zz, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309109, encodeId=1c251309109c3, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355290, encodeId=8ed01355290d5, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Sep 22 13:38:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345992, encodeId=b866345992e6, content=学习了学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/9L7RSS4HNFbWiaCxQ9SMPJePqZcxoSkZ4YFzjfb8mcJqUxy3WsbFOMV2IoVFg2l7fAiaXAJcS7g7b2IIORVp1UKQ/132, createdBy=7e952039862, createdName=183****8264, createdTime=Fri Sep 21 09:52:44 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345913, encodeId=4a8c3459136c, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri Sep 21 00:02:43 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345910, encodeId=3d5c34591067, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu Sep 20 23:47:39 CST 2018, time=2018-09-20, status=1, ipAttribution=)]
    2018-09-20 1209e435m98(暂无昵称)

    学习了，谢谢分享

    0

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