咀嚼口香糖对胃癌术后患者胃肠功能恢复效果的系统评价

Effects of chewing gum on gastrointestinal function recovery after gastric cancer surgery: a Meta-analysis

目的:系统评价咀嚼口香糖对胃癌术后患者胃肠功能恢复的治疗效果。方法:计算机检索Cochrane Library、PubMed、Embase、CINAHL、Web of Science、中国生物医学文献数据库、中国期刊全文数据库、维普中文科技期刊全文数据库和万方科技期刊全文数据库,纳入比较胃癌术后咀嚼口香糖与常规护理方式对患者胃肠功能恢复影响的随机对照试验(RCT)。对纳入研究进行偏倚评价后提取数据,采用Revman 5.3进行Meta分析。结果:纳入10项RCTs,共计853例患者。结果显示,咀嚼口香糖可以缩短患者术后首次肛门排气时间[MD=-15.07,95%CI(-20.01,-10.13),P<0.001]、术后首次排便时间[MD=-17.59,95%CI(-21.60,-13.57),P<0.001]、术后首次闻及肠鸣音时间[MD=-5.89,95%CI(-6.97,-4.82),P<0.001],减少腹胀发生率[RR=0.17,95%CI(0.08,0.35),P<0.001],缩短患者术后住院时间[MD=-1.93,95%CI(-3.17,-0.68),P=0.002]。结论:咀嚼口香糖有助于胃癌术后患者胃肠功能的恢复,缩短患者住院时间。

Objective:To systematically evaluate the effectiveness of chewing gum on gastrointestinal function recovery of postoperative patients with gastric cancer.Methods:The Randomized Controlled Trials(RCTs)regarding chewing gum on gastrointestinal function recovery after gastric cancer surgery were collected using the Cochrane Library,PubMed,Embase,CINAHL,Web of Science,China Biomedical Literature Database(CBM),CNKI,Chinese Science and VIP Database for Chinese Technical Periodicals and WanFang Data.Data were extracted after bias risk assessment of the included studies,and Meta-analysis was performed by Revman 5.3.Results:A total of 10 RCTs with 853 patients were included.The results revealed that chewing gum after gastric cancer surgery reduced the postoperative time to first flatus[MD=-15.07,95%CI(-20.01,-10.13),P<0.001],the time of first postoperative bowel movement[MD=-17.59,95%CI(-21.60,-13.57),P<0.001],the time to first audible bowel sounds[MD=-5.89,95%CI(-6.97,-4.82),P<0.001].It also significantly decreased the incidence of abdominal bloating[RR=0.17,95%CI(0.08,0.35),P<0.001]and shortened the length of postoperative hospital stay[MD=-1.93,95%CI(-3.17,-0.68),P=0.002].Conclusion:Gum chewing can promote the recovery of gastrointestinal function in patients after gastric cancer surgery and reduce hospital stay duration.