Departments of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Klagenfurt, and Medical University Vienna, Wien, Austria.
Obstet Gynecol. 2013 Jul;122(1):85-90. doi: 10.1097/AOG.0b013e3182983e92.
To investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynecologic surgery.
In this randomized controlled trial, patients were allocated to either postoperative gum chewing every 2 hours for 15 minutes or standard postoperative care without gum chewing. The study's primary end points were time to first regular bowel sounds and time to first passage of flatus after surgery. Secondary end points were time of operation to first defecation, patient satisfaction concerning postoperative gum chewing, potential side effects of postoperative gum chewing, and potential effect of gum chewing on postoperative pain therapy.
One hundred seventy-nine patients were included in this trial. We found a significantly shorter interval between surgery and passage of first flatus in the intervention group compared with the control group (median 6.2 hours compared with 8.1 hours; P=.002) and a significantly higher rate of regular bowel sounds 3 hours (76% compared with 47%; P<.001) and 5 hours (91% compared with 78%; P=.01) after surgery. Fewer opioid analgetics were administered to patients allocated to the intervention group (P=.02). There was no significant difference in time to first defecation between groups (median 26.3 hours compared with 29.0 hours, P=.165). Gum chewing was well tolerated and well accepted by patients, and no intervention-related side effects were observed.
Gum chewing seems to have beneficial effects on bowel motility when used as an adjunct treatment in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynecologic laparoscopic surgery.
www.ClinicalTrials.gov, NCT 01549353.
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探讨腹腔镜妇科手术后咀嚼口香糖对肠道蠕动的影响。
在这项随机对照试验中，患者被分配到术后每 2 小时咀嚼口香糖 15 分钟组或标准术后护理组（不咀嚼口香糖）。该研究的主要终点是术后首次肠鸣音时间和术后首次排气时间。次要终点是手术至首次排便时间、患者对术后咀嚼口香糖的满意度、咀嚼口香糖的潜在副作用以及咀嚼口香糖对术后疼痛治疗的潜在影响。
本试验共纳入 179 例患者。与对照组相比，干预组术后首次排气时间明显缩短（中位数 6.2 小时比 8.1 小时；P=.002），术后 3 小时（76%比 47%；P<.001）和 5 小时（91%比 78%；P=.01）肠鸣音正常的比例明显更高。接受干预的患者使用阿片类镇痛药的次数减少（P=.02）。两组首次排便时间无显著差异（中位数 26.3 小时比 29.0 小时，P=.165）。咀嚼口香糖耐受性良好，患者接受度高，未观察到与干预相关的副作用。
咀嚼口香糖作为微创手术后辅助治疗可对肠道蠕动产生有益影响。应向妇科腹腔镜手术后的患者推荐咀嚼口香糖。
www.ClinicalTrials.gov，NCT 01549353。
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