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口香糖对结直肠癌术后肠道功能恢复的影响：一项系统评价与Meta分析

Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.

作者信息

Mei Binbin, Wang Wenting, Cui Feifei, Wen Zunjia, Shen Meifen

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Soochow University & School of Nursing Soochow University, Suzhou 215006, China.

Department of Intensive Care Unit, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.

出版信息

Gastroenterol Res Pract. 2017;2017:3087904. doi: 10.1155/2017/3087904. Epub 2017 Oct 8.

DOI:10.1155/2017/3087904
PMID:29312450
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5651113/
Abstract

BACKGROUND

This meta-analysis was performed to assess the efficacy and safety of chewing gum in intestinal function recovery after colorectal cancer surgery.

METHODS

A systematic search was conducted in PubMed, Embase, Science Direct, and Cochrane library for relevant randomized controlled trials (RCTs) published until April 2017. Summary risk ratios or weighted mean differences with 95% confidence intervals were used for continuous and dichotomous outcomes, respectively.

RESULTS

17 RCTs with a total number of 1845 patients were included. Gum chewing following colorectal cancer surgery significantly reduced the time to first passage of flatus (WMD -0.55; 95% CI -0.94 to -0.16; = 0.006), first bowel movement (WMD -0.60; 95% CI -0.87 to -0.33; < 0.0001), start feeding (WMD -1.32; 95% CI -2.18 to -0.46; = 0.003), and the length of postoperative hospital stay (WMD -0.88; 95% CI -1.59 to -0.17; = 0.01), but no obvious differences were found in postoperative nausea, vomiting, abdominal distention, pneumonia, and mortality, which were consistent with the findings of intention to treat analysis.

CONCLUSIONS

Chewing gum could accelerate the recovery of intestinal function after colorectal cancer surgery. However, it confers no advantage in postoperative clinical complications. Further large-scale and high-quality RCTs should be conducted to confirm these results.

摘要

背景

本荟萃分析旨在评估口香糖在结直肠癌手术后肠道功能恢复中的有效性和安全性。

方法

在PubMed、Embase、Science Direct和Cochrane图书馆中进行系统检索，以查找截至2017年4月发表的相关随机对照试验（RCT）。连续和二分结局分别使用95%置信区间的汇总风险比或加权平均差。

结果

纳入17项RCT，共1845例患者。结直肠癌手术后嚼口香糖显著缩短了首次排气时间（加权平均差-0.55；95%置信区间-0.94至-0.16；P=0.006）、首次排便时间（加权平均差-0.60；95%置信区间-0.87至-0.33；P<0.0001）、开始进食时间（加权平均差-1.32；95%置信区间-2.18至-0.46；P=0.003）和术后住院时间（加权平均差-0.88；95%置信区间-1.59至-0.17；P=0.01），但在术后恶心、呕吐、腹胀、肺炎和死亡率方面未发现明显差异，这与意向性分析结果一致。

结论

嚼口香糖可加速结直肠癌手术后肠道功能的恢复。然而，在术后临床并发症方面并无优势。应进行进一步的大规模、高质量RCT以证实这些结果。

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