直肠癌术后咀嚼口香糖促进胃肠康复的随机对照研究

A randomized controlled trial of chewing gum to promote postoperative bowel recovery for patients with rectal cancer

目的探讨直肠癌术后咀嚼口香糖促进胃肠功能恢复的有效性。方法前瞻性纳入2010年1～7月行择期直肠癌手术的患者160例,并随机分为实验组(n=80)和对照组(n=80)。实验组术后咀嚼口香糖,对照组术后不咀嚼口香糖。盲法采集术后胃肠功能恢复情况和胃肠道并发症指标,并比较两组间的差异。结果本研究实际纳入患者155例,实验组78例,对照组77例,两组患者基线情况一致。所有纳入患者均能良好耐受术后咀嚼口香糖。实验组术后首次闻及肠鸣音时间(P=0.036),首次排气时间、首次排便时间和术后住院时间明显短于对照组(P<0.001)。实验组术后腹胀和术后肠梗阻的发生率明显低于对照组(P<0.01),术后恶心、呕吐的发生率两组间差异无统计学意义(P>0.05)。结论直肠癌术后咀嚼口香糖能够促进患者术后胃肠功能的恢复,减轻术后胃肠道不适,缩短住院日,提高生活质量。

Objective To determine the effectiveness of chewing gum in promoting postoperative bowel recovery for pa- tients with rectal cancer. Methods Prospectively enrolled 160 patients underwent elective rectal cancer from January 2010 to July 2010, were randomly assigned into two groups. The patients in experimental group （n = 80） were given gum for chewing postoper- atively, while nothing was offered to control group （n = 80 ）. The outcomes were blindly assessed and compared between two groups, including postoperative bowel function recovery situation and complications. Results 155 patients underwent rectal canc- er were enrolled in experimental group （n = 78 ） and control group （n = 77）. The baselines characteristics of two groups were sta- tistically similar. All the patients tolerated chewing gum well. The postoperative intestinal sounds first heard was significantly shor- ter in experimental group as compared to control group （P =0. 036）, as well as passage of first flatus, first bowel movement and length of postoperative hospital stay（ P 〈 0. 001 ）. Moreover, the incidence of abdominal distension and ileus was significantly lower in experimental group as compared to control group （P 〈 0. 01 ）. However, no statistical difference was found in occurrence of postoperative nausea, vomiting （ P 〉 0. 05 ）. Conclusion Chewing gum for patients with rectal cancer could enhance the postoperative bowel fnnction recovery, relieve gastrointestinal disconffort, shorten the hospital stay, and finally improve the postoperative quality of life.