Ulasi Ikechukwu Bartholomew, Afuwape Oladolapo Olawunmi, Ayandipo Omobolaji Oladayo, Fakoya Adegbolahan, Irabor David Omoareghan
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.
J West Afr Coll Surg. 2023 Oct-Dec;13(4):46-57. doi: 10.4103/jwas.jwas_38_23. Epub 2023 Sep 16.
Postoperative ileus remains the most common cause of prolonged hospital stay after abdominal surgery. Various agents have been tested in the treatment of postoperative ileus but no agent alone has achieved effectiveness as postoperative ileus is of multifactorial aetiology.
The aim of this study was to assess the effects of combined use of gum-chewing and parenteral metoclopramide on the duration of postoperative ileus after abdominal surgery.
This was a randomised controlled study of patients aged 16-65 years who underwent elective abdominal surgeries. Patients were randomised into a gum-metoclopramide (GM) group, a gum-only (G) group, a metoclopramide-only (M) group and a control (C) group. Patients in the GM group chewed gum and received intravenous metoclopramide, each 8 hourly. In G group, patients chewed only gum, whereas those in M group received only 10mg of intravenous metoclopramide, 8 hourly. To C group, 10 mL of intravenous sterile water was given 8 hourly. Patients were monitored for time to passage of first flatus or faeces. Groups were compared for the duration of postoperative ileus and duration of hospital stay using analysis of variance. Statistical significance was set at a value of <0.05.
Fifty-two out of the 105 recruited patients were eligible for analysis. The male-to-female ratio was 1:1.9 with a median age of 57.0 years (interquartile range [IQR] =16 years). Prolonged postoperative ileus occurred in 9.4% ( 5) of the patients (GM = 2, G = 1, M = 2, C = 0; = 0.604) and was associated with longer duration of nasogastric tube use ( = 0.028). The duration of postoperative ileus was 3 days (IQR = 2), 2.5 days (IQR = 3.3), 4 days (IQR = 1.5) and 3 days (IQR = 2) in the GM, G, M, and C groups, respectively ( = 0.317), whereas the median duration of hospital stay was 7 days (IQR = 3), shortest in G group (6.5 days, IQR = 8) and longest in M group (9 days, IQR = 3) ( = 0.143).
The combined use of gum-chewing and parenteral metoclopramide had no effect on the duration of postoperative ileus following abdominal surgeries in adult surgical patients.
术后肠梗阻仍是腹部手术后延长住院时间的最常见原因。已对多种药物进行了术后肠梗阻治疗的测试，但由于术后肠梗阻病因多因素，尚无单一药物取得有效效果。
本研究旨在评估咀嚼口香糖与胃肠外使用胃复安联合应用对腹部手术后术后肠梗阻持续时间的影响。
这是一项针对16 - 65岁接受择期腹部手术患者的随机对照研究。患者被随机分为口香糖 - 胃复安（GM）组、仅口香糖（G）组、仅胃复安（M）组和对照组（C）。GM组患者每8小时咀嚼口香糖并接受静脉注射胃复安。G组患者仅咀嚼口香糖，而M组患者每8小时仅接受10mg静脉注射胃复安。C组患者每8小时静脉注射10mL无菌水。监测患者首次排气或排便的时间。使用方差分析比较各组术后肠梗阻持续时间和住院时间。设定统计学显著性水平为<0.05。
105名招募患者中有52名符合分析条件。男女比例为1:1.9，中位年龄为57.0岁（四分位间距[IQR]=16岁）。9.4%（5名）患者发生术后肠梗阻延长（GM组 = 2名，G组 = 1名，M组 = 2名，C组 = 0名；P = 0.604），且与鼻胃管使用时间延长相关（P = 0.028）。GM组、G组、M组和C组术后肠梗阻持续时间分别为3天（IQR = 2）、2.5天（IQR = 3.3）、4天（IQR = 1.5）和3天（IQR = 2）（P = 0.317），而住院中位时间分别为7天（IQR = 3），G组最短（6.5天，IQR = 8），M组最长（9天，IQR = 3）（P = 0.143）。
咀嚼口香糖与胃肠外使用胃复安联合应用对成年外科手术患者腹部手术后的术后肠梗阻持续时间无影响。
