剖宫产术后咀嚼口香糖促进肠道功能恢复的系统评价_《中国循证医学杂志》

作者：

袁远霞 ¹ ,  赵红利 ¹ , 何佳 ² , 龚钿 ¹

1. 眉山市人民医院妇产科（四川眉山?620010）；2. 四川大学华西医院中国循证医学中心（成都?610041）;

关键词：

剖宫产咀嚼口香糖术后肠梗阻肠道功能系统评价

DOI：

10.7507/1672-2531.20110074

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价剖宫产术后咀嚼口香糖促进肠道功能恢复的有效效和安全性。
方法　计算机检索Cochrane Library、MEDLINE、EMbase和中国生物医学文献数据库，检索时间从建库至2010年，纳入比较剖宫产术后咀嚼口香糖与其他治疗方式促进肠道功能恢复的随机对照试验，在对纳入研究的偏倚风险进行评估后，采用RevMan 5.0.22软件进行Meta分析。
结果　共纳入3个随机对照试验，共745例患者。Meta分析结果显示：剖宫产术后咀嚼口香糖可以缩短患者术后首次肛门排气时间［MD= –6.54， 95%CI（–7.82，–5.27），P lt;0.000 01］，减少术后肠梗阻的发生［RR= 0.54，95% CI（0.34，0.87），P=0.01］，可能缩短住院时间［MD= –0.21， 95%CI（–0.39，–0.03），P=0.02］。目前尚缺乏足够的数据支持剖宫产术后咀嚼口香糖的安全性。
结论　剖宫产术后咀嚼口香糖可以促进患者术后胃肠功能恢复，减少术后肠梗阻的发生。但由于纳入研究数较少，方法学质量不高，因此尚需更多高质量研究以增加论证强度。

引用本文： 袁远霞,赵红利,何佳,龚钿. 剖宫产术后咀嚼口香糖促进肠道功能恢复的系统评价. 中国循证医学杂志, 2011, 11(4): 427-432. doi: 10.7507/1672-2531.20110074 复制

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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《中国循证医学杂志》

剖宫产术后咀嚼口香糖促进肠道功能恢复的系统评价

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