Hu Caihong, Fei Kuilin, Liu Yuelan, Jiang Xiaoe, Yong Wenjing, Zhang Weishe, Li Ping
Department of Obstetrics, Xiangya Hospital, Central South University, Changsha 410008, China.
Hunan Engineering Research Center of Early Life Development and Disease Prevention, Xiangya Hospital, Central South University, Changsha 410008, China.
Matern Fetal Med. 2024 Apr 4;6(2):78-83. doi: 10.1097/FM9.0000000000000224. eCollection 2024 Apr.
To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.
This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student's t test and Chi-squared test, with significance set at < 0.05.
Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 18.06 ± 6.34 hours ( = 0.003) and 26.34 ± 8.21 7.05 ± 1.26 hours ( = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 4.84 ± 0.18 days ( = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 4.91 ± 0.27 ( = 0.000) and 9.36 ± 0.16 9.72 ± 0.08 ( = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( > 0.05).
Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.
确定下肢肌肉力量恢复正常后恢复常规饮食在促进择期剖宫产术后恢复中的作用。
这是一项前瞻性观察性队列研究。2022年10月至2022年12月在中南大学湘雅医院接受择期剖宫产的患者，根据术后禁食时间分为两组：观察组在下肢肌肉力量恢复后恢复进食，而对照组遵循传统的术后禁食指南，等待6小时后进食。主要结局包括通过视觉模拟量表（VAS）疼痛评分评估的术后疼痛程度和首次排气时间。还评估了人口统计学特征、首次泌乳时间、住院时间和患者满意度。采用Student's t检验和卡方检验进行统计分析，显著性设定为<0.05。
总共300例患者中，240例纳入分析，其中对照组112例，观察组128例。基线人口统计学特征无显著差异。对照组和观察组首次排气时间的中位数分别为33.37±1.22、18.06±6.34小时（P = 0.003），首次泌乳时间的中位数分别为26.34±8.21、7.05±1.26小时（P = 0.001）。对照组和观察组的住院时间中位数分别为6.54±0.53、4.84±0.18天（P = 0.000）。对照组和观察组术后VAS疼痛评分中位数和患者满意度值分别为8.57±0.11、4.91±0.27（P = 0.000）和9.36±0.16、9.72±0.08（P = 0.005）。其他术后结局，如肠梗阻、感染和42天内再入院，无统计学显著差异（P>0.05）。
下肢肌肉力量恢复后进食可改善首次排气、减轻术后疼痛、缩短住院时间并提高择期剖宫产术后的满意度，且无不良影响。这对术后康复至关重要，应予以鼓励。
