咀嚼口香糖在后路脊柱融合术治疗青少年特发性脊柱侧凸中的应用：一项随机对照试验。
Usage of Chewing Gum in Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial.
机构信息
Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
出版信息
Spine (Phila Pa 1976). 2017 Oct 1;42(19):1427-1433. doi: 10.1097/BRS.0000000000002135.
STUDY DESIGN
Randomized controlled trial.
OBJECTIVE
The present study investigated the effectiveness of chewing gum on promoting faster bowel function and its ability to hasten recovery for patients with adolescent idiopathic scoliosis (AIS) after posterior spinal fusion (PSF) surgery.
SUMMARY OF BACKGROUND DATA
Sham feeding with chewing gum had been reported to reduce the incidence of postoperative ileus by accelerating recovery of bowel function.
METHODS
We prospectively recruited and randomized 60 patients with AIS scheduled for PSF surgery into treatment (chewing gum) and control group. The patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth were assessed and recorded at 12, 24, 36, 48, and 60 hours postoperatively. The timing for the first fluid intake, first oral intake, sitting up, walking, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay were also assessed and recorded.
RESULTS
We found that there were no significant differences (P > 0.05) in patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth between treatment (chewing gum) and control groups. We also found that there were no significant difference (P > 0.05) in postoperative recovery parameters, which were the first fluid intake, first oral intake, sitting up after surgery, walking after surgery, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay between both groups. The wound pain was the worst at 12 hours postoperatively, which progressively improved in both groups. The abdominal pain progressively worsened to the highest score at 48 hours in the treatment group and 36 hours in the control group before improving after that. The pattern of severity and recovery of wound pain and abdominal pain was different.
CONCLUSION
We found that chewing gum did not significantly reduce the abdominal pain, promote faster bowel function, or hasten patient recovery.
LEVEL OF EVIDENCE
研究设计
随机对照试验。
目的
本研究旨在探讨咀嚼口香糖对促进青少年特发性脊柱侧凸（AIS）患者后路脊柱融合（PSF）术后肠道功能恢复的有效性及其促进康复的能力。
背景资料概要
咀嚼口香糖假饲已被报道通过加速肠道功能恢复来降低术后肠梗阻的发生率。
方法
我们前瞻性招募并随机将 60 例拟行 PSF 手术的 AIS 患者分为治疗（咀嚼口香糖）组和对照组。在术后 12、24、36、48 和 60 小时评估并记录患者自控麻醉使用、伤口疼痛评分、腹痛评分、恶心评分和腹围。记录首次液体摄入、首次口服摄入、坐起、行走、术后首次排气、术后首次排便以及住院时间。
结果
我们发现，治疗（咀嚼口香糖）组和对照组在患者自控麻醉使用、伤口疼痛评分、腹痛评分、恶心评分和腹围方面均无显著差异（P＞0.05）。我们还发现，两组在术后恢复参数方面也无显著差异（P＞0.05），即首次液体摄入、首次口服摄入、术后坐起、术后行走、术后首次排气、术后首次排便以及住院时间。术后 12 小时疼痛最严重，两组疼痛均逐渐缓解。腹痛逐渐加重，治疗组在术后 48 小时达到最高评分，对照组在术后 36 小时达到最高评分，之后才开始缓解。伤口疼痛和腹痛的严重程度和恢复模式不同。
结论
我们发现咀嚼口香糖并不能显著减轻腹痛、促进更快的肠道功能恢复或加速患者康复。
证据等级
1 级。
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