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剖宫产术后早期喂养对胃肠道并发症的影响。

Effect of early post cesarean feeding on gastrointestinal complications.

作者信息

Adeli Mohadese, Razmjoo Nastaran, Tara Fatemeh, Ebrahimzade Saeed

机构信息

Torbateheydariyeh University of Medical Sciences, Torbateheydariyeh, IR Iran.

Department of Midwifery, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran.

出版信息

Nurs Midwifery Stud. 2013 Jun;2(2):176-81. doi: 10.5812/nms.10184. Epub 2013 Jun 27.

Abstract

BACKGROUND

Gastrointestinal complications are the main complication in patients after cesarean section. Previous studies have reported different results about the effect of early post cesarean feeding on vomiting, nausea, flatulence and illus.

OBJECTIVES

To identify the effect of early post cesarean feeding on gastrointestinal complications.

MATERIALS AND METHODS

This randomized controlled trial was conducted on 82 women who underwent cesarean section in Mashhad Omolbanin hospital. They were randomly assigned to two equal experimental and control groups. The experimental group started oral fluids four hours after surgery, followed by a regular diet after bowel sounds returned. Mothers in the control group received fluid intravenously during the initial 12 hours, and then if bowel sounds were heard, they were permitted to receive oral fluids and they could start a solid diet if they had defecation. Vomiting and flatulence were assessed with a visual analog scale. Nausea was assessed with an observation questionnaire and illus was assessed via bowel sounds, gas passing and defecation 4, 12, 24, 36 and 48, hours post surgery in the two groups. Also, they were studied for the time of gas passing, bowel sound return, defecation, sitting, walking and breast-feeding. Data were analyzed using the chi-square, Fisher's exact test, t-test and Man-Whitney U test.

RESULTS

No mother experienced nausea, vomiting and illus. Flatulence severity 4 and 12 hours after surgery was similar in both groups (P = 0.856, P = 0.392). However, flatulence severity 24, 36 and 48 hours after surgery, was less in the experimental group (P = 0.030, P = 0.016, P = 0.001). Also, bowel sound return, time of gas passing, defecation, sitting and walking were less in the experimental group (P = 0.001).

CONCLUSION

This study showed that early feeding decreased post cesarean gastrointestinal complications.

摘要

背景

胃肠道并发症是剖宫产术后患者的主要并发症。既往研究报道了剖宫产术后早期进食对呕吐、恶心、腹胀及肠梗阻影响的不同结果。

目的

确定剖宫产术后早期进食对胃肠道并发症的影响。

材料与方法

本随机对照试验在马什哈德奥莫尔巴宁医院对82例行剖宫产的女性进行。她们被随机分为两个相等的试验组和对照组。试验组术后4小时开始口服流食,肠鸣音恢复后改为常规饮食。对照组母亲在最初12小时内静脉输液,然后如果听到肠鸣音,允许口服流食,如有排便则可开始固体饮食。用视觉模拟量表评估呕吐和腹胀情况。用观察问卷评估恶心情况,并在术后4、12、24、36和48小时通过肠鸣音、排气和排便情况评估肠梗阻情况。此外,还研究了两组患者的排气时间、肠鸣音恢复时间、排便时间、坐起时间、行走时间及母乳喂养情况。采用卡方检验、Fisher精确检验、t检验和曼-惠特尼U检验分析数据。

结果

无母亲出现恶心、呕吐及肠梗阻情况。两组术后4小时和12小时腹胀严重程度相似(P = 0.856,P = 0.392)。然而,试验组术后24、36和48小时腹胀严重程度较低(P = 0.030,P = 0.016,P = 0.001)。此外,试验组肠鸣音恢复时间、排气时间、排便时间、坐起时间及行走时间均较短(P = 0.001)。

结论

本研究表明早期进食可减少剖宫产术后胃肠道并发症。

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