膳食纤维对根治性子宫切除术后肠道功能的影响：一项随机试验。

The effect of dietary fiber on bowel function following radical hysterectomy: a randomized trial.

作者信息

Griffenberg L, Morris M, Atkinson N, Levenback C

机构信息

Department of Clinical Nutrition, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

出版信息

Gynecol Oncol. 1997 Sep;66(3):417-24. doi: 10.1006/gyno.1997.4797.

DOI:10.1006/gyno.1997.4797

PMID:9299255

Abstract

OBJECTIVE

To assess the effect of high-fiber dietary instruction in relieving chronic constipation, a known and accepted complication of radical hysterectomy (RH).

METHODS

Thirty-five women with a diagnosis of cervical cancer who were scheduled for RH were randomized into groups that followed either a high-fiber diet plan or their usual diet. Data were gathered using a validated subjective bowel function questionnaire (SBFQ); a typical day's intake form and food frequency tool; and a diary used to record food, medication, bowel, and exercise information. Patients were evaluated at 1, 4, and 7 months after surgery.

RESULTS

Postoperatively, the dietary fiber intake was significantly higher for the treatment (T) group (22.9 g) than the control (C) group (12.4 g) (P = 0.007). With regard to intergroup comparisons, there were few differences at the first follow-up. By the second visit, the T group reported taking medications to achieve regularity less often (P = 0.0269), straining less often (P = 0.0210), having pain with bowel movement (BM) less often (P = 0.0116), and having crampy abdominal pain less often (P = 0.123) than the C group. Four significant positive changes occurred in the T group, whereas only one occurred in the C group. With regard to intragroup comparison, the significant changes in bowel function in the T group were generally positive, whereas all of the C group's significant changes were negative. According to summary questions on the SBFQ, the T group reported a significant change in the frequency of BM (P = 0.0096); however, the C group reported no significant changes. Analysis of bowel function records showed clearer differences. The T group took less time to defecate (P < 0. 001) but had more BMs accompanied by gas (P < 0.001). The C group had significantly more BMs with cramps (P < 0.001), straining (P < 0. 001), and retention (P < 0.001) and significantly more BMs, which were hard (P < 0.001). Two C patients dropped out of the study because of severe bowel dysfunction despite maximum medication.

CONCLUSION

Dietary management seems to be an inexpensive effective therapeutic intervention for addressing bowel dysfunction associated with RH.

摘要

目的

评估高纤维饮食指导对缓解根治性子宫切除术（RH）已知且公认的并发症——慢性便秘的效果。

方法

将35名被诊断为宫颈癌且计划接受RH的女性随机分为两组，一组遵循高纤维饮食计划，另一组遵循其日常饮食。使用经过验证的主观肠道功能问卷（SBFQ）、典型一天的摄入量表格和食物频率工具以及用于记录食物、药物、排便和运动信息的日记收集数据。在术后1个月、4个月和7个月对患者进行评估。

结果

术后，治疗（T）组的膳食纤维摄入量（22.9克）显著高于对照组（C）组（12.4克）（P = 0.007）。在组间比较方面，第一次随访时差异不大。到第二次就诊时，T组报告使用药物来实现规律排便的频率更低（P = 0.0269），用力排便的频率更低（P = 0.0210），排便时疼痛的频率更低（P = 0.0116），以及腹部绞痛的频率更低（P = 0.123）。T组出现了四项显著的积极变化，而C组仅出现了一项。在组内比较方面，T组肠道功能的显著变化总体上是积极的，而C组的所有显著变化都是消极的。根据SBFQ上的总结问题，T组报告排便频率有显著变化（P = 0.0096）；然而，C组报告无显著变化。对肠道功能记录的分析显示差异更明显。T组排便时间更短（P < 0.001），但伴有气体的排便次数更多（P < 0.001）。C组伴有痉挛（P < 0.001）、用力排便（P < 0.001）和便秘（P < 0.001）的排便次数显著更多，且硬便的排便次数显著更多（P < 0.001）。两名C组患者因尽管使用了最大剂量药物但仍出现严重肠道功能障碍而退出研究。