Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Heling ¹ ,  JIANG Yanhua ¹ , WU Chuanmei ¹ , CHEN Yanli ¹ , TANG Qiuyue ¹ , LUO Shan ¹ , WANG Yaqin ¹ , LIAO Jia ¹ , WEI Xing ¹ , DAI Zhen ² , DAI Wei ¹ , SHI Qiuling ³

1. Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;
2. Chengdu Center for Disease Control and Prevention, Chengdu, 610041, P. R. China;
3. Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;

Corresponding author：

JIANG Yanhua, Email: 1544693323@qq.com

Keywords：

Lung cancer; postoperative constipation; influencing factor; morphine

DOI：

10.7507/1007-4848.202109021

Video：

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Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

Citation： ZHOU Heling, JIANG Yanhua, WU Chuanmei, CHEN Yanli, TANG Qiuyue, LUO Shan, WANG Yaqin, LIAO Jia, WEI Xing, DAI Zhen, DAI Wei, SHI Qiuling. Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(10): 1402-1406. doi: 10.7507/1007-4848.202109021 Copy

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3.	郑中龙, 李涛, 卿松. 全程管理体系在肺癌患者术后便秘的预防及治疗中的应用. 黑龙江医学, 2020, 44(8): 1013-1015.
4.	李丹凤, 张兰, 张宏敏. 复方丁香开胃贴联合中药穴位贴敷治疗肺癌患者术后便秘疗效研究. 陕西中医, 2018, 39(10): 1375-1377.
5.	王豫鲜, 孔红武, 杜晶晶, 等. 腹部推拿联合穴位贴敷治疗老年患者肺癌术后便秘的效果观察. 中国现代医生, 2020, 58(28): 166-169.
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8.	张远强, 魏星, 谢少华, 等. 肺切除患者术后住院期间阿片类药物应用情况及其影响因素的回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(7): 909-913.
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10.	张立力, 臧瑜. MD安德森症状评估量表肺癌模块的修订和考评. 肿瘤, 2013, 33(5): 434-438.
11.	李春蕊, 张雯, 樊碧发. 数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较. 中国疼痛医学杂志, 2016, 22(9): 683-686.
12.	Swarm RA, Paice JA, Anghelescu DL, et al. Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2019, 17(8): 977-1007.
13.	吕恒刚, 宋云平, 郭莘. 便秘的危害及预防. 解放军预防医学杂志, 2019, 37(8): 198.
14.	彭彬, 李国锋. 便通胶囊防治胸腔镜术后便秘的随机对照研究. 世界中医药, 2020, 15(18): 2772-2775, 2780.
15.	杨梅, 周倩. 甲状腺疾病病人术后便秘现状及其影响因素. 护理研究, 2018, 32(23): 3733-3737.
16.	胡燕, 陆晶晶, 叶艺, 等. 胃癌患者术后早期下床活动的最佳证据应用. 上海护理, 2021, 21(5): 22-26.
17.	周晓琪, 颜巧元, 谭翠莲. 胃肠道恶性肿瘤患者术后便秘的原因及治疗护理进展. 现代临床护理, 2017, 16(6): 76-81.
18.	高寅丽, 李利亚, 李佩文. 癌症患者便秘原因分析与治疗进展. 中国中医急症, 2009, 18(1): 115-117.
19.	彭燕, 宋金春, 李荣凌, 等. 2009—2010年我院术后镇痛药应用分析. 中国医院用药评价与分析, 2012, 12(1): 48-50.
20.	姚真, 徐晓婉, 刘敏, 等. 癌痛患者阿片类药源性便秘护理干预进展. 护士进修杂志, 2017, 32(6): 508-510.
21.	Wall T, Sherwin A, Ma D, et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br J Anaesth, 2019, 123(2): 135-150.
22.	吴鸽, 林沈娴, 朱奇, 等. 阿片类药物是否穷途末路? 中国疼痛医学杂志, 2021, 27(3): 212-215.
23.	王稳, 孙莉. 阿片类药物相关性便秘的研究进展. 中国疼痛医学杂志, 2016, 22(5): 378-382.
24.	赵炳媛, 刘凤, 姜桂春, 等. 肿瘤患者阿片类药物相关性便秘严重程度现状及影响因素分析. 护理学报, 2019, 26(11): 9-14.
25.	Imai H, Fumita S, Harada T, et al. Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): A post hoc subgroup analysis of patients with lung cancer. Jpn J Clin Oncol, 2021, 51(3): 444-450.
26.	Farmer AD, Holt CB, Downes TJ, et al. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol, 2018, 3(3): 203-212.
27.	许陶. 肿瘤患者阿片类药物所致便秘严重程度调查及相关因素分析. 护理实践与研究, 2020, 17(21): 32-34.
28.	杨梅, 牛玲莉, 郑娥, 等. 基于加速康复外科理念肺癌患者出院准备度与出院指导质量现状及相关性分析. 中国胸心血管外科临床杂志, 2019, 26(9): 905-909.

1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
2. 中国医师协会肿瘤医师分会, 中国医疗保健国际交流促进会肿瘤内科分会. Ⅳ期原发性肺癌中国治疗指南(2021年版). 中华肿瘤杂志, 2021, 43(1): 39-59.
3. 郑中龙, 李涛, 卿松. 全程管理体系在肺癌患者术后便秘的预防及治疗中的应用. 黑龙江医学, 2020, 44(8): 1013-1015.
4. 李丹凤, 张兰, 张宏敏. 复方丁香开胃贴联合中药穴位贴敷治疗肺癌患者术后便秘疗效研究. 陕西中医, 2018, 39(10): 1375-1377.
5. 王豫鲜, 孔红武, 杜晶晶, 等. 腹部推拿联合穴位贴敷治疗老年患者肺癌术后便秘的效果观察. 中国现代医生, 2020, 58(28): 166-169.
6. 陈群英, 肖娟. 胸腰椎骨折术后患者发生便秘的影响因素分析. 解放军护理杂志, 2014, 31(9): 43-46.
7. Dai W, Xie S, Zhang R, et al. Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: A multicentre, prospective, observational cohort study protocol. BMJ Open, 2019, 9(10): e030726.
8. 张远强, 魏星, 谢少华, 等. 肺切除患者术后住院期间阿片类药物应用情况及其影响因素的回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(7): 909-913.
9. Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: The validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist, 2011, 16(2): 217-227.
10. 张立力, 臧瑜. MD安德森症状评估量表肺癌模块的修订和考评. 肿瘤, 2013, 33(5): 434-438.
11. 李春蕊, 张雯, 樊碧发. 数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较. 中国疼痛医学杂志, 2016, 22(9): 683-686.
12. Swarm RA, Paice JA, Anghelescu DL, et al. Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2019, 17(8): 977-1007.
13. 吕恒刚, 宋云平, 郭莘. 便秘的危害及预防. 解放军预防医学杂志, 2019, 37(8): 198.
14. 彭彬, 李国锋. 便通胶囊防治胸腔镜术后便秘的随机对照研究. 世界中医药, 2020, 15(18): 2772-2775, 2780.
15. 杨梅, 周倩. 甲状腺疾病病人术后便秘现状及其影响因素. 护理研究, 2018, 32(23): 3733-3737.
16. 胡燕, 陆晶晶, 叶艺, 等. 胃癌患者术后早期下床活动的最佳证据应用. 上海护理, 2021, 21(5): 22-26.
17. 周晓琪, 颜巧元, 谭翠莲. 胃肠道恶性肿瘤患者术后便秘的原因及治疗护理进展. 现代临床护理, 2017, 16(6): 76-81.
18. 高寅丽, 李利亚, 李佩文. 癌症患者便秘原因分析与治疗进展. 中国中医急症, 2009, 18(1): 115-117.
19. 彭燕, 宋金春, 李荣凌, 等. 2009—2010年我院术后镇痛药应用分析. 中国医院用药评价与分析, 2012, 12(1): 48-50.
20. 姚真, 徐晓婉, 刘敏, 等. 癌痛患者阿片类药源性便秘护理干预进展. 护士进修杂志, 2017, 32(6): 508-510.
21. Wall T, Sherwin A, Ma D, et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br J Anaesth, 2019, 123(2): 135-150.
22. 吴鸽, 林沈娴, 朱奇, 等. 阿片类药物是否穷途末路? 中国疼痛医学杂志, 2021, 27(3): 212-215.
23. 王稳, 孙莉. 阿片类药物相关性便秘的研究进展. 中国疼痛医学杂志, 2016, 22(5): 378-382.
24. 赵炳媛, 刘凤, 姜桂春, 等. 肿瘤患者阿片类药物相关性便秘严重程度现状及影响因素分析. 护理学报, 2019, 26(11): 9-14.
25. Imai H, Fumita S, Harada T, et al. Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): A post hoc subgroup analysis of patients with lung cancer. Jpn J Clin Oncol, 2021, 51(3): 444-450.
26. Farmer AD, Holt CB, Downes TJ, et al. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol, 2018, 3(3): 203-212.
27. 许陶. 肿瘤患者阿片类药物所致便秘严重程度调查及相关因素分析. 护理实践与研究, 2020, 17(21): 32-34.
28. 杨梅, 牛玲莉, 郑娥, 等. 基于加速康复外科理念肺癌患者出院准备度与出院指导质量现状及相关性分析. 中国胸心血管外科临床杂志, 2019, 26(9): 905-909.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization

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