Aims: To evaluate the feasibility and efficacy of Mirabilite combined with Lactulose in older patients after abdominal surgery.
Design: It is a retrospective observational cohort study with a pre and post intervention group.
Methods: Medical records were retrospectively reviewed of postoperative Intensive Care patients with postoperative gastrointestinal tract dysfunction (aged >60 years) in the Surgical Intensive Care Unit from January 2017-December 2018.
Results: One hundred and sixty-seven post-surgical Intensive Care patients with postoperative gastrointestinal tract dysfunction were analysed; 74 patients received Mirabilite + Lactulose treatment and 93 patients received Lactulose treatment. The recovery rate of bowel sounds was better in the Mirabilite + Lactulose group (62.16%) compared with the Lactulose group (37.63%) after 3-day treatment (p = 0.002) and the relative risk (RR) was 1.65 (95% CI, 1.20, 2.27). Moreover 70.27% patients in the Mirabilite + Lactulose group finally had flatus or defecation compared with 46.24% patients in Lactulose group (p = 0.003) and the RR was 1.52 (1.17, 1.98). The abdominal girth and Inter Abdominal Pressure in Mirabilite + Lactulose group showed significantly greater decrease over a 3-day period compared with Lactulose group (4.86 vs. 3.46 cm, p = 0.027; 4.80 vs. 3.11 mmHg, p = 0.002 respectively). The pain score had greater decrease from the baseline in Mirabilite + Lactulose group than in Lactulose group (2.40 vs. 1.11; p < 0.01). Patients in the Mirabilite + Lactulose group had shorter hospital stay than the Lactulose group 12.5 (SD 3.51) versus 13.9 (SD 5.14), p = 0.05.
Conclusions: This study demonstrated that external use of Mirabilite combined with Lactulose can be considered as an easy intervention to improve postoperative gastrointestinal mobility in older intensive care patients who suffer from postoperative gastrointestinal tract dysfunction after surgery.
Impact: Our results provide a great option to alleviate the sufferings of postoperative patients. The externally use Mirabilite is a painless and safe interventions that is easy to implement by ICU nurses.
目的: 探讨芒硝联合乳果糖治疗老年患者腹部手术的可行性及疗效。 设计: 此为一项回顾性观测队列研究,研究对象分为干预前和干预后两组。 方法: 2017年1月至2018年12月间,对60岁以上外科重症监护病房术后胃肠道功能障碍的重症监护患者的病历资料进行回顾性分析。 结果: 现已对167例术后胃肠道功能障碍的重症监护患者进行分析;其中,74例接受芒硝+乳果糖治疗,93例单独接受乳果糖治疗。治疗后3天,芒硝+乳果糖组的肠鸣音恢复率(62.16%)优于乳果糖组(37.63%)(p = 0.002),相对危险度(RR)为1.65(95%CI,1.20,2.27)。此外,芒硝+乳果糖组中,70.27%的患者最终出现胀气或排便,而乳果糖组的数值仅为46.24%(p = 0.003),相对危险度为1.52(1.17,1.98)。相较于乳果糖组,芒硝+乳果糖组患者的腹围和内腹压在3天内显著降低(分别为4.86 vs. 3.46 cm, p = 0.027;4.80 vs. 3.11 mmHg,p = 0.002)。相较于乳果糖组,芒硝+乳果糖组的疼痛评分较基线下降明显(2.40 vs. 1.11;p < 0.01)。芒硝+乳果糖组患者的住院时间比乳果糖组短,为12.5(SD 3.51)比13.9(SD 5.14),p=0.05。 结论: 本研究表明,芒硝联合乳果糖外用可作为简单的干预措施,帮助改善术后胃肠道功能障碍重症监护患者的术后胃肠道蠕动。 影响: 根据研究结果,患者有更多的选择,以减轻术后痛苦。芒硝外用可作为一种干预措施,无痛、安全且易于重症监护室的护士实施。.
Keywords: Mirabilite; intensive care; intra-abdominal surgery; nursing; postoperative gastrointestinal mobility.
© 2020 John Wiley & Sons Ltd.