目的评价厚朴排气合剂治疗手术所致胃肠动力障碍的效果及安全性。方法检索Pub Med、EMBASE、Cochrane Library、Web of Knowledge、中国科学引文数据库、中国知网、维普数据库及万方数据库,检索时间为各数据库建库至2015年3月。纳入应...目的评价厚朴排气合剂治疗手术所致胃肠动力障碍的效果及安全性。方法检索Pub Med、EMBASE、Cochrane Library、Web of Knowledge、中国科学引文数据库、中国知网、维普数据库及万方数据库,检索时间为各数据库建库至2015年3月。纳入应用厚朴排气合剂治疗各类手术后胃肠动力障碍的随机对照试验。由2名研究者独立筛选文献并提取数据及进行文献质量评价,采用Stata 12软件和Rev Man 5.3软件对主要结局指标术后肛门首次排气时间及次要结局指标术后首次排便时间、肠鸣音恢复时间进行Meta分析。结果共纳入符合标准的文献16篇,总样本量为2247例。仅有4篇文献报道了具体的随机分配方法。Meta分析结果显示,厚朴排气合剂对腹部非胃肠吻合术、妇科手术、剖宫产术等各类术后胃肠动力障碍均具有明确的疗效,能显著缩短术后首次排气时间(WMD=-11.82,95%CI:-14.80^-8.84,P<0.01;WMD=-18.19,95%CI:-27.58^-8.79,P<0.01;WMD=-10.95,95%CI:-16.22^-5.69,P<0.01)、排便时间(WMD=-8.58,95%CI:-15.95^-1.21,P=0.02;WMD=-28.4,95%CI:-35.4^-20.68,P<0.01;WMD=-15.74,95%CI:-30.29^-1.20,P=0.03)及肠鸣音恢复时间(WMD=-3.52,95%CI:-5.08^-1.96,P<0.01;WMD=-8.68,95%CI:-10.37^-6.99,P<0.01;WMD=-9.58,95%CI:-14.16^-5.01,P<0.01),未见明显的药物不良反应。结论厚朴排气合剂用于术后胃肠动力障碍的治疗效果明确,短期使用未发现明显的药物不良反应。展开更多
AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, ...AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification. METHODS: Fifty patients underwent elective colorectal surgery In a regional medical center. Patients were prosp-ectively randomized into a Gastrografin group or control group (n=25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student's t-test. RESULTS: In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3±0.3 d in the Gastrografin group VS 4.8±0.4 d in the control group; P=odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6±1.1 d in the Gastrografin group VS 10.2±1.3 d in the control group; P=odds ratio--, 95% CI [-1.2 to +1.4 d]). CONCLUSION: Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.展开更多
文摘目的评价厚朴排气合剂治疗手术所致胃肠动力障碍的效果及安全性。方法检索Pub Med、EMBASE、Cochrane Library、Web of Knowledge、中国科学引文数据库、中国知网、维普数据库及万方数据库,检索时间为各数据库建库至2015年3月。纳入应用厚朴排气合剂治疗各类手术后胃肠动力障碍的随机对照试验。由2名研究者独立筛选文献并提取数据及进行文献质量评价,采用Stata 12软件和Rev Man 5.3软件对主要结局指标术后肛门首次排气时间及次要结局指标术后首次排便时间、肠鸣音恢复时间进行Meta分析。结果共纳入符合标准的文献16篇,总样本量为2247例。仅有4篇文献报道了具体的随机分配方法。Meta分析结果显示,厚朴排气合剂对腹部非胃肠吻合术、妇科手术、剖宫产术等各类术后胃肠动力障碍均具有明确的疗效,能显著缩短术后首次排气时间(WMD=-11.82,95%CI:-14.80^-8.84,P<0.01;WMD=-18.19,95%CI:-27.58^-8.79,P<0.01;WMD=-10.95,95%CI:-16.22^-5.69,P<0.01)、排便时间(WMD=-8.58,95%CI:-15.95^-1.21,P=0.02;WMD=-28.4,95%CI:-35.4^-20.68,P<0.01;WMD=-15.74,95%CI:-30.29^-1.20,P=0.03)及肠鸣音恢复时间(WMD=-3.52,95%CI:-5.08^-1.96,P<0.01;WMD=-8.68,95%CI:-10.37^-6.99,P<0.01;WMD=-9.58,95%CI:-14.16^-5.01,P<0.01),未见明显的药物不良反应。结论厚朴排气合剂用于术后胃肠动力障碍的治疗效果明确,短期使用未发现明显的药物不良反应。
文摘AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification. METHODS: Fifty patients underwent elective colorectal surgery In a regional medical center. Patients were prosp-ectively randomized into a Gastrografin group or control group (n=25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student's t-test. RESULTS: In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3±0.3 d in the Gastrografin group VS 4.8±0.4 d in the control group; P=odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6±1.1 d in the Gastrografin group VS 10.2±1.3 d in the control group; P=odds ratio--, 95% CI [-1.2 to +1.4 d]). CONCLUSION: Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.
