目的:评估腹腔镜妇科手术后咀嚼口香糖对患者胃肠功能的影响。
方法:我们筛选了5个主要数据库(Medline,Scopus,谷歌学者,Cochrane中央对照试验和临床试验登记册.gov)从开始到2023年2月。
方法:没有语言限制。我们纳入了随机对照试验,比较了腹腔镜妇科手术后咀嚼的患者和不咀嚼口香糖的患者的术后肠功能,以获得良性适应症。
结果:从来自670名患者的5项研究中提取数据,并由3名独立评审员进行分析。使用RevMan5.4软件进行Meta分析(哥本哈根:北欧Cochrane中心,科克伦合作,2020),具有平均差异(MD),集合风险比(RR)和随机效应模型。术后咀嚼口香糖显着减少了首次肠鸣音的时间和首次排气的时间(MD-2.58小时95%CI-4.12至-1.04p=.001和MD-3.97小时95%CI-6.26至-1.68p<.001,分别)。第一次排便的时间,患者术后第一次动员的时间,住院时间,两组术后肠梗阻的风险无统计学差异。当根据腹腔镜手术的类型进行亚组分析时,它未能揭示术后咀嚼口香糖对腹腔镜子宫切除术后首次排气和首次排便的积极影响(MD-5.35小时95%CI-10.93~0.23p=.06和MD-15.93小时95%CI-40.13~8.28p=.20).
结论:本荟萃分析的结果支持腹腔镜妇科手术后咀嚼口香糖似乎对胃肠道的早期动员有积极作用。然而,这些结果应谨慎解释,因为纳入的RCT数量较少.
OBJECTIVE: To assess the effect of postoperative gum chewing on gastrointestinal function in women following laparoscopic gynecological surgery for benign indications.
METHODS: We screened 5 major databases (Medline, Scopus, Google Scholar, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov) from inception till February 2023.
METHODS: No language restrictions were applied. We included randomized controlled trials comparing the postoperative bowel function between patients who chewed and patients who did not chew gum postoperatively after laparoscopic gynecological procedures for benign indications.
RESULTS: Data from 5 studies on 670 patients were extracted and analyzed by 3 independent reviewers. Meta-analysis was performed with RevMan 5.4 software (Copenhagen: The Nordic Cochrane Center, The Cochrane Collaboration, 2020), with mean differences (MDs), pooled risk ratios, and random-effects model. Postoperative gum chewing significantly reduced the time to first bowel sounds and the time to first passage of flatus (MD -2.58 hours 95% confidence interval (CI) -4.12 to -1.04 p = .001 and MD -3.97 hours 95% CI -6.26 to -1.68 p <.001, respectively). The time to first defecation, the time to first postoperative patients\' mobilization, the length of hospital stay, and the risk of postoperative bowel obstruction showed no statistically significant difference between the 2 groups. When subgroup analysis was performed according to the type of the laparoscopic procedure, it failed to reveal a positive impact of postoperative gum chewing in both the times to first passage of flatus and first defecation following laparoscopic hysterectomies (MD -5.35 hours 95% CI -10.93 to 0.23 p = .06 and MD -15.93 hours 95% CI -40.13 to 8.28 p = .20, respectively).
CONCLUSIONS: The results of the present meta-analysis support that postoperative gum chewing following laparoscopic gynecological procedures seems to have a positive effect on the early mobilization of the gastrointestinal tract. However, these results should be interpreted with caution due to the small number of the included randomized controlled clinical trials.