目的 比较腹部超声波排气法与腹部手法按摩两种健康干预方法在预防癌痛患者阿片类药物诱发便秘(OIC)中的应用效果.方法 选取2016年8月至2017年7月在四川省肿瘤医院就诊的接受癌痛规范化治疗且口服强阿片类镇痛药的患者196例,采用随机抽签法分为超声组和手法组,超声组(100例)采取腹部超声波排气技术,手法组(96例)采取腹部手法按摩,两组均加常规缓泻剂,均从强阿片类镇痛药滴定开始时进行干预,疼痛控制时间和标准采用“321或331快速滴定方案”,观察两组患者从住院首次接受强阿片类药物治疗开始到出院后3个月便秘发生情况.结果 两组癌痛患者一般资料比较差异无统计学意义(P＞0.05);超声组便秘发生率(17.0％,17/100例)低于手法组(30.2％,29/96例),差异有统计学意义(P＜0.05);两组癌痛患者发生便秘后排便方式差异无统计学意义(P＞0.05);超声组便秘发生时间较手法组推迟,差异有统计学意义(P＜0.05).结论 腹部超声波排气法能有效促进肠蠕动,降低OIC的发生率,延缓OIC的发生时间.%Objective To compare the effects of abdominal ultrasonic exhaust therapy and abdominal massage on prevention of opioid-induced constipation (OIC) in patients with cancer pain.Methods One hundred and ninety-six patients received standardized treatment of cancer pain and oral strong opioid analgesics at Sichuan Cancer Hospital from August 2016 to July 2017,were randomly divided into two groups by random draw method:ultrasonic exhaust group (100 cases)and massage group (96 cases).Patients received abdominal ultrasound exhaust therapy plus conventional laxative agent in ultrasonic exhaust group,while received abdomen massage and conventional laxatives in massage group.Time and criteria for pain control were measured using the "321 or 331 rapid titration protocol".The occurrence of constipation was observed from begining strong opioid therapy to three months after discharge.Results There was no significant difference in the basic condition of patients with cancer pain between the two groups (P＞0.05).The incidence of constipation was lower in ultrasonic exhaust group (17.0％,17/100 cases) than that in massage group (30.2％,29/96 cases) (P＜0.05).No difference was found in the way of defecation after constipation between the two groups of cancer pain patients (P＞0.05).The occurrent time of constipation was delayed significantly in ultrasonic exhaust group (P＜0.05).Conclusion The abdominal ultrasonic exhaust method can effectively promote intestine peristalsis,reduce the incidence of OIC and delay its occurrence time.
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