Ge Bujun, Zhao Hongmei, Lin Rui, Wang Jialiang, Chen Quanning, Liu Liming, Huang Qi
Department of General Surgery, Tongji Hospital Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Medicine (Baltimore). 2017 Mar;96(13):e6501. doi: 10.1097/MD.0000000000006501.
In some studies, gum-chewing was demonstrated to have a beneficial effect on resumption of bowel function; however, other contradictory findings in other studies refute the effects of gum-chewing on peristaltic movements and digestive system stimulation. In addition, most previous studies were after colorectal or gynecology surgery, whereas few reports focused on the effect of gum-chewing after gastrectomy. The aim of this randomized controlled trial was to assess the effectiveness of gum-chewing on postoperative bowel function in patients who had undergone laparoscopic gastrectomy.
From March 2014 to March 2016, 75 patients with gastric cancer received elective laparoscopic surgery in Shanghai Tongji hospital and were postoperatively randomly divided into 2 groups: 38 in a gum-chewing (Gum) group and 37 in a control (No gum) group. The patients in the Gum group chewed sugarless gum 3 times daily, each time for at least 15 minutes, until the day of postoperative exhaust defecation.
The mean time to first flatus (83.4 ± 35.6 vs. 79.2 ± 24.2 hours; P = 0.554) and the mean time to first defecation (125.7 ± 41.2 vs. 115.4 ± 34.2 hours; P = 0.192) were no different between the no gum and Gum groups. There was also no significant difference in the incidence of postoperative ileus (P = 0.896) and postoperative hospital stay (P = 0.109) between the 2 groups. The postoperative pain score at 48 hours (P = 0.032) in the Gum group was significantly higher than in the no gum group. There was no significant difference between the 2 groups in regards to patient demographics, comorbidities, duration of surgery, complications, and nausea/vomiting score.
Gum-chewing after laparoscopic gastrectomy did not hasten the return of gastrointestinal function. In addition, gum-chewing may increase patient pain on the second postoperative day.
在一些研究中，嚼口香糖被证明对肠道功能恢复有有益作用；然而，其他研究中的矛盾结果反驳了嚼口香糖对蠕动运动和消化系统刺激的影响。此外，大多数先前的研究是在结直肠或妇科手术后进行的，而很少有报告关注嚼口香糖在胃切除术后的效果。这项随机对照试验的目的是评估嚼口香糖对接受腹腔镜胃切除术患者术后肠道功能的有效性。
2014年3月至2016年3月，75例胃癌患者在上海同济医院接受择期腹腔镜手术，术后随机分为2组：嚼口香糖（口香糖）组38例，对照组（不嚼口香糖）组37例。口香糖组患者每天嚼无糖口香糖3次，每次至少15分钟，直至术后排气排便当天。
不嚼口香糖组和嚼口香糖组首次排气的平均时间（83.4±35.6 vs. 79.2±24.2小时；P = 0.554）和首次排便的平均时间（125.7±41.2 vs. 115.4±34.2小时；P = 0.192）没有差异。两组术后肠梗阻的发生率（P = 0.896）和术后住院时间（P = 0.109）也没有显著差异。嚼口香糖组术后48小时的疼痛评分（P = 0.032）显著高于不嚼口香糖组。两组在患者人口统计学、合并症、手术时间、并发症和恶心/呕吐评分方面没有显著差异。
腹腔镜胃切除术后嚼口香糖并不能加速胃肠功能的恢复。此外，嚼口香糖可能会增加患者术后第二天的疼痛。
