作者：赖淑蓉，赖小令，张四芳，祝胜宁

单位：中山大学附属第一医院 胃肠外科中心，广东 广州 510080

Authors:  LAI Shurong, LAI Xiaoling, ZHANG Sifang, ZHU ShengNing

Unit:  Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

目的   探讨咀嚼口香糖对腹腔镜下结直肠癌术后肠功能恢复的影响。方法  将胃肠中心结直肠癌术后患者随机分为观察组与对照组:分两组,共60例,口香糖组29例,对照组31例,男38例,女22例,平均59.9岁。对照组在加速康复应用下,早期下床活动;实验组在对照组的基础上咀嚼口香糖。结果  口香糖组和对照组术后肠鸣音恢复时间分别为28.6±8.1小时、32.5±4.8小时(p=0.021);术后肛门排气时间分别为40.2±12.9小时、48.3±11.3)小时(p=0.020);术后住院天数分别为5.2±1.2天、5.9±0.8天(p=0.017)。口香糖组患者术后患者首次肠鸣音时间、肛门排气及术后住院天数早于对照组,差异有统计学意义(P<0.05)。实验组术后腹胀0例,术后恶心1例(3.4%),呕吐0例,对照组术后腹胀1例(3.2%),术后恶心10例(32.0%),术后呕吐4例(12.9),患者术后腹胀、恶心、呕吐较对照组降低。结论  咀嚼口香糖对腹腔镜下结直肠癌术后早期肠鸣音恢复及肛门排气具有一定促进作用,缩短术后住院时间,可以降低术后腹胀、恶心、呕吐情况。

关键词： 口香糖; 肠鸣音; 肛门排气; 结直肠癌; 加速康复

Abstract：

Objective  To investigate the effect of gum chewing on the intestinal function in colorectal cancer patients after laparoscopic colectomy. Methods  Colorectal cancer patients receiving laparoscopic colectomy for colorectal cancer were randomly assigned to treatment and control groups. Totally 60 patients were enrolled in this study, with 29 patients in the experiment group and 31 patients in the control group. There were 38 male and 22 female patients, and the average age of the patients was 59.9 years. All patients are managed based on the philosophy of Enhanced Recovery After Surgery (ERAS). The experiment group also chewed gum. Results  The recovery time of bowel sound in the experiment group and the control group was 28.6±8.1 hours, 32.5±4.8 hours, respectively (p=0.021). Postoperative anal exhaust time was 40.2±12.9 hours vs 48.3±11.3 hours (p=0.020). Postoperative hospitalization time were 5.2±1.2 vs 5.9±0.8 days (p=0.017). The gum chewing group showed shorter bowel sounds recovery time, anus exhaust time and post-operative hospitalization days than the control group. All of the above difference was statistically significant (p<0.05). In the experiment group, post-operative abdominal distention was observed in 0 case, postoperative nausea was observed in 1 case (3.4%), and postoperative vomiting was observed in 0 case. In the control group, 1 (3.4%), 10 (32%) and 4 (12.9%) cases were observed respectively. Conclusions  Gum chewing can promote the recovery of early bowel sound and anal exhaust after laparoscopic colorectal cancer surgery. Gum chewing can shorten postoperative hospital stay, and reduce postoperative abdominal distension, nausea and vomiting.

Key Words:  Gum chewing; Bowel sound; Anal exhaust; Colorectal cancer; ERAS