Department of Urology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
BJOG. 2014 Jun;121(7):787-92. doi: 10.1111/1471-0528.12662. Epub 2014 Mar 14.
Gum chewing has been reported to enhance bowel motility and reduce postoperative ileus (POI). However, the efficacy remains imprecise for women following caesarean section.
To summarise and evaluate the current evidence for postoperative gum chewing on the recovery of bowel function following caesarean section.
We searched studies from the following electronic databases: PubMed, EMBASE, SCOPUS and Cochrane Library from inception to 30 May 2013.
We included randomised controlled trials (RCTs) of women after caesarean section; these RCTs should compared gum chewing with no gum chewing and reported on at least one of the outcomes: time to flatus, time to bowel sound, time to passing stool and length of hospital stay (LOS).
Study outcomes were presented as mean differences (for continuous data) with 95% confidence interval (95% CI). The risk of bias in the study results was assessed using the assessment tool from the Cochrane Handbook.
Six RCTs including 939 women were included in our meta-analysis. The pooled results demonstrated that gum chewing is superior to no gum chewing with a reduction of 6.42 hours (95% CI -7.55 to -5.29) for time to first flatus, 3.62 hours (95% CI -6.41 to -0.83) for time to first bowel sound, 6.58 hours (95% CI -10.10 to -3.07) for time to first stool and 5.94 hours (95% CI -9.39 to -2.49) for LOS. In addition, no evidence emerged for any side effects caused by gum chewing.
The current evidence suggests that gum chewing is associated with early recovery of bowel motility and shorter LOS for women after caesarean section. This safe and inexpensive intervention should be included in routine postoperative care following a caesarean section.
咀嚼口香糖已被报道能增强肠道蠕动并减少术后肠梗阻（POI）。然而，在剖宫产术后妇女中的疗效仍不明确。
总结和评估剖宫产术后咀嚼口香糖对肠道功能恢复的现有证据。
我们从以下电子数据库中检索研究：PubMed、EMBASE、SCOPUS 和 Cochrane Library，检索时间截至 2013 年 5 月 30 日。
我们纳入了剖宫产术后女性的随机对照试验（RCT）；这些 RCT 应比较咀嚼口香糖与不咀嚼口香糖，并报告至少一个结果：排气时间、肠鸣音时间、排便时间和住院时间（LOS）。
研究结果以均值差（对于连续数据）表示，置信区间（95%CI）为 95%。使用 Cochrane 手册的评估工具评估研究结果的偏倚风险。
我们的荟萃分析纳入了 6 项 RCT 共 939 名女性。汇总结果表明，咀嚼口香糖优于不咀嚼口香糖，首次排气时间缩短 6.42 小时（95%CI -7.55 至 -5.29），首次肠鸣音时间缩短 3.62 小时（95%CI -6.41 至 -0.83），首次排便时间缩短 6.58 小时（95%CI -10.10 至 -3.07），住院时间缩短 5.94 小时（95%CI -9.39 至 -2.49）。此外，没有证据表明咀嚼口香糖会产生任何副作用。
现有证据表明，咀嚼口香糖与剖宫产术后女性肠道蠕动的早期恢复和 LOS 缩短有关。这种安全且廉价的干预措施应纳入剖宫产术后的常规术后护理中。
