Cavuşoğlu Y H, Azili M N, Karaman A, Aslan M K, Karaman I, Erdoğan D, Tütün O
Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.
Eur J Pediatr Surg. 2009 Jun;19(3):171-3. doi: 10.1055/s-0029-1202776. Epub 2009 Apr 9.
The aim of this study was to determine whether the addition of gum chewing to standardized postoperative care is associated with a significantly earlier return of bowel function compared to simple postoperative management in children with intestinal anastomosis.
We performed a prospective, randomized, controlled trial. All patients who underwent laparotomy with either colon or small bowel resection between June 2006 and March 2008 were randomized to one of two groups. Group one consisted of patients receiving standardized postoperative care plus gum chewing (gum-chewing group) (n=15); Group two consisted of patients receiving only standardized postoperative care (control group) (n=15). The patients in the gum-chewing group chewed one stick of sugarless gum three times per day, for an hour, each day.
The groups were statistically similar. The time to first flatus was 35.73+/-14.67 h in the gum-chewing group and 42.00+/-20.77 h in the control group (p=0.347). The time to first bowel movement was 56.27+/-22.14 h in the gum-chewing group and 63.00+/-26.34 in the control group (p=0.444). The length of hospital stay was 5.80+/-0.68 days for the gum-chewing group and 6.67+/-0.98 days for the control group (p=0.005). The hospital charges were 2451+/-806 YTL for the gum-chewing group and 2102+/-678 YTL for the control group (p=0.206).
The addition of gum chewing to the standardized postoperative care of children with intestinal anastomosis was not associated with a significantly earlier return of bowel function compared to simple postoperative management, but it was associated with an earlier discharge from hospital, although this earlier discharge had only minor clinical significance and no difference was found in hospital charges.
本研究的目的是确定与单纯术后管理相比，在标准化术后护理中增加嚼口香糖是否与肠吻合术患儿的肠功能恢复明显更早相关。
我们进行了一项前瞻性、随机、对照试验。2006年6月至2008年3月期间接受结肠或小肠切除术的所有开腹手术患者被随机分为两组。第一组由接受标准化术后护理加嚼口香糖的患者组成（嚼口香糖组）（n = 15）；第二组由仅接受标准化术后护理的患者组成（对照组）（n = 15）。嚼口香糖组的患者每天咀嚼无糖口香糖三次，每次一小时。
两组在统计学上相似。嚼口香糖组首次排气时间为35.73±14.67小时，对照组为42.00±20.77小时（p = 0.347）。嚼口香糖组首次排便时间为56.27±22.14小时，对照组为63.00±26.34小时（p = 0.444）。嚼口香糖组住院时间为5.80±0.68天，对照组为6.67±0.98天（p = 0.005）。嚼口香糖组的住院费用为2451±806土耳其里拉，对照组为2102±678土耳其里拉（p = 0.206）。
与单纯术后管理相比，在肠吻合术患儿的标准化术后护理中增加嚼口香糖与肠功能恢复明显更早无关，但与更早出院有关，尽管这种更早出院仅具有较小的临床意义，且住院费用无差异。
