Objective To explore the effect of perioperative early warning nursing on abdominal distension and constipation after lumbar decompression and fusion. Methods Patients with lumbar degenerative diseases admitted to the Department of orthopaedics of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from January 2022 to January 2023 were randomly divided into the early warning nursing group (observation group) and the routine nursing group (control group) by using the random number table method. The number and situation of postoperative abdominal distension and constipation patients, anxiety and satisfaction with nursing work were recorded. Results A total of 120 patients were included in this study. There were 60 in the observation group and 60 in the control group. There was no significant difference in gender, age, marital status and educational level between the two groups (P > 0.05). The number of patients with abdominal distension (15) and the abdominal distension degree score (0.48 ± 0.93) in the observation group were significantly lower than those in the control group (35; 1.30 ± 1.24). The statistical values of the two groups were = 8.717, t = -3.354, respectively (P < 0.05); The number of patients with constipation (21) and the score of constipation degree (0.60 ± 0.96) in the observation group were significantly lower than those in the control group (38; 1.38 ± 1.19). The statistical values of the two groups were = 6.054 respectively. t=-3.209（P<0.05）； The score of self rating Anxiety Scale in the observation group (50.70 ± 8.26) was significantly lower than that in the control group (57.68 ± 10.63), t = -3.278 (P < 0.05); The survey score of nursing satisfaction in the observation group (8.95 ± 0.99) was significantly higher than that in the control group (8.13 ± 1.56) t = 2.833 (P < 0.05). Conclusion Early warning nursing during the perioperative period can effectively reduce the number of patients with abdominal distension and constipation after operation, improve the symptoms of abdominal distension and constipation, improve the anxiety of patients after operation, improve the satisfaction of patients with nursing, and help patients recover better.