剖宮產術后咀嚼口香糖促進腸道功能恢復的系統評價_《中國循證醫學雜志》

作者：

袁遠霞 ¹ ,  趙紅利 ¹ , 何佳 ² , 龔鈿 ¹

1. 眉山市人民醫院婦產科（四川眉山?620010）；2. 四川大學華西醫院中國循證醫學中心（成都?610041）;

關鍵詞：

剖宮產咀嚼口香糖術后腸梗阻腸道功能系統評價

DOI：

10.7507/1672-2531.20110074

視頻：

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目的　系統評價剖宮產術后咀嚼口香糖促進腸道功能恢復的有效效和安全性。
方法　計算機檢索Cochrane Library、MEDLINE、EMbase和中國生物醫學文獻數據庫，檢索時間從建庫至2010年，納入比較剖宮產術后咀嚼口香糖與其他治療方式促進腸道功能恢復的隨機對照試驗，在對納入研究的偏倚風險進行評估后，采用RevMan 5.0.22軟件進行Meta分析。
結果　共納入3個隨機對照試驗，共745例患者。Meta分析結果顯示：剖宮產術后咀嚼口香糖可以縮短患者術后首次肛門排氣時間［MD= –6.54， 95%CI（–7.82，–5.27），P lt;0.000 01］，減少術后腸梗阻的發生［RR= 0.54，95% CI（0.34，0.87），P=0.01］，可能縮短住院時間［MD= –0.21， 95%CI（–0.39，–0.03），P=0.02］。目前尚缺乏足夠的數據支持剖宮產術后咀嚼口香糖的安全性。
結論　剖宮產術后咀嚼口香糖可以促進患者術后胃腸功能恢復，減少術后腸梗阻的發生。但由于納入研究數較少，方法學質量不高，因此尚需更多高質量研究以增加論證強度。

引用本文： 袁遠霞,趙紅利,何佳,龔鈿. 剖宮產術后咀嚼口香糖促進腸道功能恢復的系統評價. 中國循證醫學雜志, 2011, 11(4): 427-432. doi: 10.7507/1672-2531.20110074 復制

1.	1 Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al . Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet , 2010, 375(9713): 490-499.
2.	Teoh WHL, Shah MK, Mah CL. A randomised controlled trial on beneficial effects of early feeding post-Caesarean delivery under regional anaesthesia. Singapore Med J , 2007, 48(2):152-157.
3.	Kehlet H. Postoperative ileus--an update on preventive techniques. Nat Clin Pract Gastroenterol Hepatol , 2008, 5(10): 552-558.
4.	Izbizky GH, Minig L, Sebastiani MA, et al . The effect of early versus delayed post-caesarean feeding on women’s satisfaction: a randomised controlled trial. BJOG , 2008, 115(3): 332-338.
5.	Schuster R, Grewal N, Greaney GC, et al . Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg , 2006, 141(2): 174-176.
6.	Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg , 2009, 13(4): 649-656.
7.	Purkayastha S, Tilney HS, Darzi AW, et al . Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg , 2008, 143(8): 788-793.
8.	Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum , 2007, 50(12): 2149-2157.
9.	de Castro SM, van den Esschert JW, van Heek NT, et al . A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg , 2008, 25(1): 39-45.
10.	Fitzgerald JE, Ahmed I. Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg , 2009, 33(12): 2557-2566.
11.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12.	Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, et al . Gum chewing stimulates early return of bowel motility after caesarean section. BJOG , 2009, 116(10):1334-9.
13.	Kafali H, Duvan CI, Gözdemir E, et al . Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest , 2010, 69(2): 84-87.
14.	Shang H, Yang Y, Tong X, et al . Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol , 2010, 27(5): 387-391.
15.	Carr CS, Ling KD, Boulos P, et al . Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection. BMJ , 1996, 312(7035): 869-871.
16.	Stewart BT, Woods RJ, Collopy BT, et al . Early feeding after elective open colorectal resections: a prospective randomized trial. Aust N Z J Surg , 1998, 68(2): 125-128.
17.	Basse L, Hjort Jakobsen D, Billesbølle P, et al . A clinical pathway to accelerate recovery after colonic resection. Ann Surg , 2000, 232(1): 51-57.
18.	Milov DE, Andres JM, Erhart NA, et al . Chewing gum bezoars of the gastrointestinal tract. Pediatrics , 1998, 102(2): e22.
19.	Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum--an unfortunate combination. Med J Aust , 2007, 187(11-12): 635.
20.	Matros E, Rocha F, Zinner M, et al . Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg , 2006, 202(5): 773-778.

1. 1 Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al . Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet , 2010, 375(9713): 490-499.
2. Teoh WHL, Shah MK, Mah CL. A randomised controlled trial on beneficial effects of early feeding post-Caesarean delivery under regional anaesthesia. Singapore Med J , 2007, 48(2):152-157.
3. Kehlet H. Postoperative ileus--an update on preventive techniques. Nat Clin Pract Gastroenterol Hepatol , 2008, 5(10): 552-558.
4. Izbizky GH, Minig L, Sebastiani MA, et al . The effect of early versus delayed post-caesarean feeding on women’s satisfaction: a randomised controlled trial. BJOG , 2008, 115(3): 332-338.
5. Schuster R, Grewal N, Greaney GC, et al . Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg , 2006, 141(2): 174-176.
6. Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg , 2009, 13(4): 649-656.
7. Purkayastha S, Tilney HS, Darzi AW, et al . Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg , 2008, 143(8): 788-793.
8. Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum , 2007, 50(12): 2149-2157.
9. de Castro SM, van den Esschert JW, van Heek NT, et al . A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg , 2008, 25(1): 39-45.
10. Fitzgerald JE, Ahmed I. Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg , 2009, 33(12): 2557-2566.
11. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12. Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, et al . Gum chewing stimulates early return of bowel motility after caesarean section. BJOG , 2009, 116(10):1334-9.
13. Kafali H, Duvan CI, Gözdemir E, et al . Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest , 2010, 69(2): 84-87.
14. Shang H, Yang Y, Tong X, et al . Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol , 2010, 27(5): 387-391.
15. Carr CS, Ling KD, Boulos P, et al . Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection. BMJ , 1996, 312(7035): 869-871.
16. Stewart BT, Woods RJ, Collopy BT, et al . Early feeding after elective open colorectal resections: a prospective randomized trial. Aust N Z J Surg , 1998, 68(2): 125-128.
17. Basse L, Hjort Jakobsen D, Billesbølle P, et al . A clinical pathway to accelerate recovery after colonic resection. Ann Surg , 2000, 232(1): 51-57.
18. Milov DE, Andres JM, Erhart NA, et al . Chewing gum bezoars of the gastrointestinal tract. Pediatrics , 1998, 102(2): e22.
19. Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum--an unfortunate combination. Med J Aust , 2007, 187(11-12): 635.
20. Matros E, Rocha F, Zinner M, et al . Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll Surg , 2006, 202(5): 773-778.

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剖宮產術后咀嚼口香糖促進腸道功能恢復的系統評價

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剖宮產術后咀嚼口香糖促進腸道功能恢復的系統評價

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