| Objective:This study aims to construct an intervention program for bowel dysfunction in the acute phase of spinal cord injury,and verify the effectiveness and practicability of the spinal cord injury bowel dysfunction intervention program applying in the acute phase of patients,form a clinical intervention specification for acute spinal cord injury bowel dysfunction patients,and provide a theoretical basis for clinically establishing a scientific,standard and effective management model of bowel function in the acute stage of spinal cord injury,in order to reduce the incidence of bowel dysfunction,reduce the symptoms of bowel dysfunction and improve the quality of life of patients.Methods:1.A case review and literature review method was used to preliminarily formulate an intervention program for intestinal dysfunction in the acute phase of spinal cord injury,and to demonstrate the program through an expert meeting method to make the program more scientific and operable.2.This intervention program is quasi-experimental study,totally 76 patients with spinal cord injury meeting the inclusion criteria were selected in Shanghai Sixth People’s Hospital and Shanghai Changzheng Hospital from March to December2019.We use historical control study,the patients admitted from March to May 2019were included in the control group(n=42),the patients admitted from October to December 2019 were included in the experimental group(n=34).The control group used routine nursing interventions,including dietary intervention,drug intervention,etc.The experimental group used spinal cord injury bowel dysfunction intervention programs.Patients in each group were intervened for 2 weeks,and the changes in bowel function indexes and laboratory examination indicators of the two groups were compared.Data were analyzed with SPSS Statistics 22.0,using the descriptive statistical analysis,t test,non-parametric test and chi-square test.P<0.05 was considered statistically significant.Results:1.Nine experts were selected by research group to participate in the expert meeting.The expert’s judgment on the research content of the intervention program was based on a coefficient of 0.972,a familiarity level of 0.956,an expert authority coefficient of 0.964,a high degree of expert authority,and a credible argument.2.Application effect of spinal cord injury-based bowel dysfunction intervention program in patients with acute stage(1)Comparison between groups:The incidences of abdominal distension and constipation were compared between the two groups of patients before the intervention,the differences were not statistically significant;after 2 weeks’nursing intervention,the improvement of abdominal distension and constipation in the intervention group was significantly better than that in the control group(P<0.05).(2)Comparison within groups:The comparison results showed that the incidence of constipation was lower in the control group after 2 weeks’intervention(P<0.05),but there was no significant difference in the incidence of abdominal distension and fecal incontinence(P>0.05);After 2 weeks’intervention in the intervention group,the incidence of bowel dysfunction,abdominal distension and constipation was lower than that at admission,and the differences were statistically significant(P<0.05).(3)Laboratory examination indicators such as Na~+,Hb,TP and albumin have certain hints to the patient’s bowel function,which can be incorporated into the evaluation indicators as a reference.Conclusion:Spinal cord injury bowel function intervention program can effectively improve the bowel function of spinal cord injury patients with acute phase,reduce the incidence of abdominal distension and constipation,and is worth promoting;laboratory examination indicators are suggestive for bowel management of patients with acute stage of spinal cord injury.Intervention strategies can be improved to enhance nutritional support for patients,and laboratory examination indicators are included in secondary outcome evaluation indicators. |
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