Cardiovascular Imaging Center, Samsung Medical Center, Seoul, Korea.
J Clin Nurs. 2012 Aug;21(15-16):2188-92. doi: 10.1111/j.1365-2702.2012.04132.x. Epub 2012 Jun 2.
The aim of this study was to compare the return of bowel function and xerostomia in patients who were and were not instructed to chew gum after elective open liver resection.
Patients who undergo liver resection have limited early ambulation, because they require bed rest after surgery to prevent internal bleeding. They normally also require narcotic analgesics or patient-controlled analgesia for pain control. For these reasons, they often have symptoms of intestinal gas accumulation, abdominal distension and/or abdominal pain.
Prospective case-control study.
Forty-two patients with hepatocellular carcinoma who were treated at Samsung Medical Center from September 2010 to February 2011 were included in this study. Patients who were scheduled for elective liver resection for hepatocellular carcinoma and were over 30 years of age were eligible. Patients were assigned to a gum-chewing group or a non-gum-chewing (control) group before surgery.
The mean age of the gum-chewing group was 54·9 (±9·7) years, and the mean age of the control group was 55·1 (±8·4) years. The mean values of first flatus time and xerostomia were higher in the control group than in the gum-chewing group. First flatus time and xerostomia grade were significantly decreased in gum-chewing group compared with the control group after adjustment for hospitalisation days, duration of surgery and amount of analgesics administered.
Patients who were instructed to chew gum after surgery demonstrated faster bowel function recovery and lower xerostomia grade after elective open liver resection than patients who did not chew gum.
Gum-chewing is an inexpensive, helpful adjunct to standard postoperative care after liver resection.
本研究的目的是比较接受选择性开腹肝切除术后接受和未接受咀嚼口香糖指导的患者肠功能恢复和口干情况。
接受肝切除术的患者早期活动受限，因为他们在手术后需要卧床休息以防止内出血。他们通常还需要使用麻醉性镇痛药或患者自控镇痛来控制疼痛。由于这些原因，他们常常有肠气积聚、腹胀和/或腹痛的症状。
前瞻性病例对照研究。
本研究纳入了 2010 年 9 月至 2011 年 2 月期间在三星医疗中心接受治疗的 42 例肝细胞癌患者。符合条件的患者为因肝细胞癌行择期肝切除术且年龄超过 30 岁的患者。在手术前，患者被分配到咀嚼口香糖组或不咀嚼口香糖（对照组）。
咀嚼口香糖组的平均年龄为 54.9（±9.7）岁，对照组的平均年龄为 55.1（±8.4）岁。对照组的首次排气时间和口干程度的平均值均高于咀嚼口香糖组。调整住院天数、手术持续时间和给予的镇痛药剂量后，咀嚼口香糖组的首次排气时间和口干程度明显低于对照组。
与未咀嚼口香糖的患者相比，接受术后咀嚼口香糖指导的患者在接受选择性开腹肝切除术后，肠功能恢复更快，口干程度更低。
咀嚼口香糖是肝切除术后标准术后护理的一种廉价、有益的辅助手段。
