术前咀嚼口香糖对妇科腹腔镜手术患者术后康复的影响

Effect of preoperative gum chewing on the patients’ rehabilitation after gynecologic laparoscopic surgery

目的探讨术前咀嚼口香糖对妇科腹腔镜手术患者术后康复的影响。方法选择2013年1月—5月行腹腔镜手术的妇科患者160例,随机分为试验组(n=80)和对照组(n=80)。试验组患者于术前30~60 min咀嚼1粒无糖口香糖,至少咀嚼30 min,吐出后进入手术间;对照组患者不咀嚼口香糖。记录两组患者的首次排气时间、首次排便时间、住院时间,术后2、4、6、8、24、48 h的疼痛程度,术后恶心、呕吐和腹胀的发生率,术后止吐药和镇痛药的使用率。结果试验组的首次排气时间[(16.49±7.64)h]比对照组[(20.25±7.94)h]明显缩短(P=0.003),试验组的首次排便时间[(48.16±15.25)h]比对照组[(55.80±18.97)h]明显缩短(P=0.006),试验组术后2 h的疼痛程度明显轻于对照组(P<0.05)。试验组术后恶心的发生率(43.75%)较对照组(61.25%)显著降低(P=0.027)。但两组间住院时间,术后4、6、8、24、48 h的疼痛程度,术后呕吐和腹胀的发生率,术后止吐药和镇痛药的使用率差异无统计学意义(P>0.05)。结论术前咀嚼口香糖可以促进妇科腹腔镜手术患者术后胃肠道功能的恢复和减轻术后短期内的疼痛,促进术后康复。术前咀嚼口香糖作为一种简单、便宜、安全、有效的方法可运用于临床。

Objective To investigate the effect of preoperative gum chewing on the postoperative rehabilitation of patients undergoing gynecologic laparoscopic surgery.Methods A total of 160 patients undergoing elective gynecologic laparoscopic surgery between January and May 2013 were selected to participate in the study.Each patient was randomly assigned to one of the two groups:the trial group(n=80)or the control group(n=80).Thirty to sixty minutes before the surgery,the patients in the trial group chewed one piece of sugarless gum for at least 30 minutes,and then removed the gum before being taken to the operating room;while the patients in the control group chewed nothing.The time to first passage of flatus and the time to first defecation after surgery,length of hospital stay,the degrees of pain at 2-,4-,6-,8-,24-,48-hour after surgery,the incidences of postoperative nausea,vomiting,and abdominal distension,postoperative analgesic and antiemetic drug requirement were recorded.Results The mean time to first passage of flatus was significantly earlier in the trial group than that in the control group((16.49±7.64)vs.(20.25±7.94)hours,P=0.003)The mean time to first defecation was significantly earlier in the trial group than that in the control group((48.16±15.25)vs.(55.80±18.97)hours,P=0.006)The degree of pain at 2-hour after surgery was significantly lighter in the trial group than that in the control group(P<0.05).Fewer participants in the trial group than in the control group experienced postoperative nausea(43.75%vs.61.25%,P=0.027).There were no significant differences in the length of hospital stay,the degrees of pain at 4-,6-,8-,24-and 48-hour after surgery,incidences of postoperative vomiting and abdominal distension,postoperative analgesic,or antiemetic drug requirement between the two groups(P>0.05).Conclusions Gum chewing before surgery can promote the recovery of gastrointestinal function,reduce postoperative short-term pain,and promote postoperative rehabilitation in patients undergoing gynecologic laparoscopic surgery.Gum chewing before surgery can be used clinically as an easy,inexpensive,safe,and effective procedure.