咀嚼口香糖促进妇科患者术后胃肠道功能恢复效果的Meta分析  

Effect of gum chewing on the recovery of gastrointestinal function in patients undergoing gynecological surgery:a systematic review and meta-analysis

作　　者：尹亚楠[1,2] 任建华 龙德蓉[1,2] 蒋旎洁 欧洋华[1,2] YIN Yanan;REN Jianhua;LONG Derong;JIANG Nijie;OU Yanghua(Department of Gynecological Nursing,West China Second University Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,P.R.China;Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西第二医院,成都610041 [2]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中国循证医学杂志》2021年第8期936-941,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价咀嚼口香糖促进妇科患者术后胃肠道功能恢复的效果。方法计算机检索EBSCO、MEDLINE、Web of Science、CNKI、WanFang Data和VIP数据库,搜集有关妇科患者咀嚼口香糖促进术后胃肠道功能恢复的随机对照试验(RCT),检索时限均从建库至2020年9月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入9个RCT,962例患者。Meta分析结果显示:咀嚼口香糖组患者术后肛门首次排气时间[MD=–8.34,95%CI(–10.72,–5.95),P<0.00001]、首次排便时间[MD=–14.97,95%CI(–29.28,–0.66),P=0.04]和肠鸣音恢复时间[MD=–5.83,95%CI(–10.15,–1.51),P=0.008]均短于对照组,并且腹胀发生率更低[RR=0.24,95%CI(0.08,0.74),P=0.01]。亚组分析结果显示:与对照组相比,腹腔镜手术[MD=–5.43,95%CI(–7.12,–3.73),P<0.00001]、开腹手术[MD=–10.46,95%CI(–13.56,–7.97),P<0.00001]和腹部手术[MD=–10.64,95%CI(–13.01,–8.26),P<0.00001]患者咀嚼口香糖的术后肛门首次排气时间均缩短,且开腹手术[MD=–29.18,95%CI(–46.03,–12.33),P=0.0007]和腹部手术[MD=–14.24,95%CI(–24.27,–4.21),P=0.005]患者咀嚼口香糖的术后首次排便时间缩短,但腹腔镜手术患者术后首次排便时间与对照组相比,差异不具有统计学意义[MD=–2.97,95%CI(–12.94,7.00),P=0.56]。结论现有证据表明,咀嚼口香糖能够帮助妇科术后患者缩短肛门首次排气时间、排便时间和肠鸣音恢复时间,同时降低腹胀发生率。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the effect and influence of gum chewing on the recovery of gastrointestinal function in gynecological patients after operation. Methods EBSCO, MEDLINE, Web of Science, CNKI,Wan Fang Data and VIP databases were electronically searched to collect randomized controlled trials of gum chewing on gastrointestinal function recovery in patients after gynecological surgery from inception to September 30 th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Rev Man 5.3 software was then used to perform the meta-analysis. Results A total of 9 studies were included, involving 962 patients. Metaanalysis results showed that the time of first flatus(MD=–8.34, 95%CI –10.72 to –5.95, P<0.000 01), the time of first defecation(MD=–14.97, 95%CI –29.28 to –0.66, P<0.04), and the recovery time of bowel sounds(MD=–5.83, 95%CI–10.15 to –1.51, P=0.008) of gum chewing group was significantly shorter than that of the control group, and the incidence of abdominal distension was decreased after gynecological surgery(RR=0.24, 95%CI 0.08 to 0.74, P=0.01).According to the results of subgroup analysis, the time of first flatus of the gum chewing group was significantly shorter than that of the control group in laparoscopy(MD=–5.43, 95%CI –7.12 to –3.73, P<0.000 01), laparotomy(MD=–10.46,95%CI –13.56 to –7.97, P<0.000 01) and abdominal surgery(MD=–10.64, 95%CI –13.01 to –8.26, P<0.000 01);the first defecation time after laparotomy(MD=–29.18, 95%CI –46.03 to –12.33, P=0.000 7), and abdominal surgery(MD=–14.24, 95%CI –24.27 to –4.21, P=0.005) in chewing gum group was significantly shorter than that in the control group;however, there was no significant difference in the laparoscopy group(MD=–2.97, 95%CI –12.94 to 7.00, P=0.56).Conclusions The systematic review and meta-analysis shows that gum chewing after gynecological surgery can shorten the time of first flatus, first defecation, and first bowel m

关 键 词：咀嚼口香糖 胃肠功能恢复 妇科手术 META分析 随机对照试验 

分 类 号：R713[医药卫生—妇产科学]