脑卒中后便秘与脑损伤相关因素分析  

Correlation analysis between post-stroke constipation and brain injury

作　　者：蔡文智[1,2] 王丽[1,2] 郭丽[1,2] 王静新[1] 张晓梅[1] 曹文静[1,2] 盛小燕[1,2] 

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]南方医科大学护理学院,广东广州510515

出　　处：《南方医科大学学报》2013年第1期117-120,共4页Journal of Southern Medical University

基　　金：南方医院优秀人才基金(20030012)

摘　　要：目的了解脑卒中后便秘的发生率,并探讨其与脑损伤相关因素的关系。方法采用便利抽样方法,对广州市10家医院的723例脑卒中住院患者进行问卷调查,包括人口统计学资料、脑损伤相关因素、排便情况、既往史等项目。结果 723例调查对象中便秘者共有250例,总发生率为34.6%,其中缺血性卒中便秘的发生率为31.0%,出血性卒中为44.8%,缺血合并出血为47.4%,3种类型脑卒中患者的便秘发生率的差异存在统计学意义(χ2=12.369,P=0.002);按卒中时期,急性期发生率为41.9%,恢复期31.5%,后遗症期22.6%,3个时期便秘发生率的总体比较差异有统计学意义(χ2=24.421,P<0.001);以损伤部位而言,基底节区脑卒中者便秘发生率45.1%,明显高于非基底节卒中者24.7%(P<0.001);脑损伤相关多因素分析显示:卒中类型、卒中时期、病灶数及基底节是脑卒中后便秘的影响因素。结论脑卒中患者急性期常发生便秘,以脑出血类型为主,大脑基底节区受损者便秘发生率较非基底节区高。Objective To investigate the incidence of constipation after stroke and explore the relationship between post-stroke constipation and brain injury. Methods Using a self-designed questionnaire, we collected the general information of 723 inpatients from 10 hospitals in Guangzhou, including the general demographic information, related factors of brain injury, defecation and previous history. Results The total incidence of post-stroke constipation was 34.6% in these patients. The incidence of constipation was 31.0% in ischemic stroke patients, 44.8% in hemorrhagic stroke patients, and 47.4% in patients with cerebral hemorrhage and infarction, showing a significant difference between stroke types （X2=12.369, P--0.002）. In terms of stages following stroke, the incidence was 41.6% in the acute phase, 31.5% in the recovery phase, and 22.6% in the sequelae phase. In light of lesion locations, the incidence was significantly higher in patients with basal ganglia involvement than in those without （P〈0.001）. Logistic multivariate analyses showed that stroke type, post-stroke stage, lesion number and basal ganglia involvement were significantly associated with the incidence of constipation. Conclusion Constipation often occurs in the acute stage following stroke （especially hemorrhagic stroke）, and the incidence is higher in patients with basal ganglia involvement.

关 键 词：脑卒中 便秘 脑损伤 

分 类 号：R743.3[医药卫生—神经病学与精神病学]