口香糖对胰十二指肠切除术后肠梗阻的影响——一项随机对照试验
Effects of chewing gum against postoperative ileus after pancreaticoduodenectomy--a randomized controlled trial.
作者信息
Andersson Thomas, Bjerså Kristofer, Falk Kristin, Olsén Monika Fagevik
机构信息
Department of Surgery, Sahlgrenska University Hospital, Gothenburg, S-41345, Sweden.
Division of Nursing Science, Department of Medical and Health Sciences, University of Linköping, Linköping, Sweden.
出版信息
BMC Res Notes. 2015 Feb 10;8:37. doi: 10.1186/s13104-015-0996-0.
BACKGROUND
Postoperative ileus is common after surgery. One non-pharmacological intervention that has shown promising results in reducing the duration of postoperative ileus is chewing gum after surgery. However, this has not been investigated in upper gastrointestinal surgery such as pancreatic surgery. Hence the aim of this study was to investigate the effects of chewing gum treatment on patients undergoing pancreaticoduodenectomy ad modum whipple due to pancreatic or periampullary cancer.
METHODS
This study was conducted as a phase III trial that was terminated early. Patients diagnosed with pancreatic tumours scheduled for pancreaticoduodenectomy ad modum whipple were included. The treatment group received chewing gum postoperatively and standard care. Controls received glucose solution and standard care. Chewing gum and glucose were used four times a day during the whole hospital stay. Time to first flatus and stool was defined as the primary outcome. The secondary outcome was start with clear liquids, start with liquid diet and length of hospital stay.
RESULTS
No statistically significant differences could be observed between the chewing gum intervention group and the control group. However, a numerical difference in mean time was observed in first flatus, first stool, start of clear fluids, and start of liquid diet and length of hospital stay in favour of the intervention group.
CONCLUSIONS
Although this study did not find statistically significant differences favouring the use of chewing gum for postoperative ileus, a positive trend was observed of a reduction of the impact of postoperative ileus among patients after pancreatic surgery. It also contributes valuable methodological experience that is important for future studies of chewing gum interventions during recovery after pancreatic surgery.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT02319512 , publication date 2014-12-17.
背景
术后肠梗阻在手术后很常见。一种在缩短术后肠梗阻持续时间方面显示出有前景结果的非药物干预措施是术后嚼口香糖。然而，在诸如胰腺手术等上消化道手术中尚未对此进行研究。因此，本研究的目的是调查嚼口香糖治疗对因胰腺或壶腹周围癌接受惠普尔式胰十二指肠切除术的患者的影响。
方法
本研究作为一项提前终止的III期试验进行。纳入计划接受惠普尔式胰十二指肠切除术的胰腺肿瘤患者。治疗组术后接受嚼口香糖及标准护理。对照组接受葡萄糖溶液及标准护理。在整个住院期间，每天使用4次口香糖和葡萄糖。首次排气和排便时间被定义为主要结局。次要结局为开始进清流食、开始进流食及住院时间。
结果
嚼口香糖干预组与对照组之间未观察到统计学上的显著差异。然而，在首次排气、首次排便、开始进清流食、开始进流食及住院时间方面，干预组在平均时间上存在数值差异。
结论
尽管本研究未发现支持使用嚼口香糖治疗术后肠梗阻有统计学显著差异，但观察到胰腺手术后患者术后肠梗阻影响有降低的积极趋势。它还提供了有价值的方法学经验，这对未来胰腺手术后恢复期间嚼口香糖干预的研究很重要。
试验注册
ClinicalTrials.gov标识符：NCT02319512，发布日期2014年12月17日。
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