腹腔镜术后咀嚼口香糖促进胃肠道功能恢复效果的Meta分析  

The effects of gum chewing on gastrointestinal recovery after laparoscopic surgery:a Meta-analysis

作　　者：易怀秀 顾平[1] 刘言 YI Huaixiu;GU Ping;LIU Yan(School of Nursing,Nanjing Medical University,Jiangsu,211166,China)

机构地区：[1]南京医科大学护理学院,211166

出　　处：《中国护理管理》2020年第8期1196-1203,共8页Chinese Nursing Management

基　　金：江苏高校优势学科建设工程项目“护理学”(苏政办发〔2018〕87号);“十三五”江苏省重点学科项目“护理学”(苏教研〔2016〕9号);江苏省高校品牌专业建设工程项目“护理学”(苏教高〔2015〕11号);南京医科大学(优势学科二期)“健康促进护理协同创新中心”建设项目(JX21831803/004)。

摘　　要：目的:系统评价咀嚼口香糖对促进腹腔镜术后胃肠道功能恢复的有效性。方法:计算机检索PubMed、Cochrane Library、EMbase、CINAHL、Scopus、Web of Science、中国生物医学文献数据库、中国知网、万方数据库、维普中文期刊全文数据库和读秀学术搜索,纳入比较腹腔镜术后咀嚼口香糖与其他护理方式对胃肠道功能恢复影响的随机对照试验。在评价所纳研究的偏倚风险后,用RevMan5.3软件进行Meta分析。结果:共纳入20项随机对照试验,共1?869例患者。Meta分析结果显示,咀嚼口香糖可以缩短腹腔镜术后首次肛门排气时间[MD=-8.35,95%CI(-10.46,-6.24),P<0.001],缩短术后首次排便时间[MD=-9.92,95%CI(-12.74,-7.10),P<0.001],缩短术后首次闻及肠鸣音的时间[MD:-4.32,95%CI(-5.72,-2.91),P<0.001],减少腹胀发生率[RR=0.29,95%CI(0.22,0.37),P<0.001]和减少术后住院天数[MD=-0.49,95%CI(-0.82,-0.16),P=0.004]。结论:咀嚼口香糖可以促进腹腔镜术后胃肠功能恢复,减少腹胀的发生率,缩短患者住院时间,但仍需高质量随机对照试验加以论证。Objective:To systematically evaluate the effectiveness of gum chewing to promote gastrointestinal function recovery after laparoscopic surgery.Methods:The Randomized Controlled Trials(RCTs)regarding gum chewing on gastrointestinal recovery after Laparoscopic surgery were collected using the following databases:PubMed,the Cochrane Library,Embase,and CINAHL,Scopus,Web of Science,Chinese biomedical literature database,China National Knowledge Infrastructure,WanFang Data,Chinese Science and Technology Periodical Databases and Duxiu Knowledge Search.A quantitative systemic review(Meta-analysis)was conducted by using RevMan 5.3 software after the evaluation of the risk of bias.Results:A total of 20 RCTs with a total of 1869 patients were included.Meta-analysis revealed that early gum chewing could shorten the first anal exhaust time[MD=-8.35,95%CI(-10.46,-6.24),P<0.001],the first defecation time[MD=-9.92,95%CI(-12.74,-7.10),P<0.001],the first bowel sound time[MD=-4.32,95%CI(-5.72,-2.91),P<0.001]after laparoscopic surgery.It could also reduce the incidence of postoperative abdominal distension[RR=0.29,95%CI(0.22,0.37),P<0.001]and shorten the days of hospital stay[MD=-0.49,95%CI(-0.82,-0.16),P=0.004].Conclusion:Early gum chewing can promote the recovery of gastrointestinal function after laparoscopic surgery,reduce the incidence of abdominal distension and shorten the days of hospital stay for patients.However,high-quality RCTs are still greatly needed to demonstrate the effects in the future.

关 键 词：腹腔镜手术 咀嚼口香糖 胃肠道功能 META分析 

分 类 号：R47[医药卫生—护理学]