胃肠术后早期咀嚼口香糖促进胃肠道功能恢复效果的系统评价

Effect of early gum chewing on gastrointestinal recovery after gastrointestinal surgery:a systematic review

目的系统评价胃肠术后早期咀嚼口香糖对促进胃肠道功能恢复的有效性。方法计算机检索Cochrane图书馆、PubMed、EMbase、EBSCO、Ovid、中国科技期刊数据库(VIP)、中国学术期刊全文数据库(CNKI)、万方科技期刊全文数据库,纳入比较胃肠术后早期咀嚼口香糖与其他治疗方式对胃肠道功能恢复的随机对照试验,在对纳入研究的偏倚风险进行评价后,采用RevMan 4.3.2软件进行meta分析。结果共纳入12个随机对照试验,共749例患者。meta分析结果显示:胃肠术后早期咀嚼口香糖可以缩短术后首次肛门排气时间[WMD=-16.22,95%CI(-21.90,-10.55),P<0.00001],缩短术后首次闻及肠鸣音的时间[WMD=-22.82,95%CI(-38.29,-7.35),P=0.004],促进缩短术后首次肛门排便时间[WMD=-20.52,95%CI(-32.00,-9.04),P=0.0005],缩短住院时间[WMD=-36.84,95%CI(-59.26,-14.41),P=0.001]。结论胃肠术后早期咀嚼口香糖可以促进胃肠道术后胃肠功能恢复,缩短患者住院时间。但今后需高质量的大样本随机双盲实验增加论证强度。

Objective To systematically review the effect of early gum chewing on the recovery of gastrointestinal functioning after gastrointestinal surgery. Methods The randomised controlled trials （RCT）on early gum chewing after gastrointestinal surgery were collected using the databases of Cochrane Library,PubMed,EMbase,EBSCO,Ovid,Chinese Science and Technology Periodical Databases（VIP）,China National Knowledge Infrastructure（CNKI） and WanFang Data. After selection and critical appraisal of the retrieved studied,a quantitative systemic review（Meta-analysis）was conducted by RevMan 4.3.2 software. Results Twelve RCTs with 749 patients were included. Meta-analysis revealed that early gum chewing after gastrointestinal surgery could significantly shorten the time to first flatus[WMD=-16.22,95%CI（-21.90,-10.55）,P〈0.00001] ,time to first bowel motion [ WMD=-22.82,95% CI （ -38.29, -7.35 ）, P=0.004 ], time to first passage of feces [ WMD=-20.52,95% CI （-32.00, -9.04 ）, P=0.0005 ], and duration of hospital stay[WMD=-36.84,95%CI（-59.26,-14.41）,P=0.001]. Conclusion Early gum chewing after gastrointestinal surgery is beneficial in promoting the recovery of gastrointestinal functioning and reducing length of hospital stay. However, more high quality RCTs are still required to verify the effects.