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臺灣醫學

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篇名 咀嚼口香糖對降低結腸切除術後腸阻塞之功效
卷期 19:4
並列篇名 The Effect of Chewing Gum on Reducing Postoperative lieus after Colorectal Surgery
作者 董婉君謝伶瑜
頁次 327-334
關鍵字 咀嚼口香糖腸阻塞結腸切除術統合分析chewing gumileuscolorectal surgerymeta-analysisTSCI
出刊日期 201507
DOI 10.6320/FJM.2015.19(4).01

中文摘要

術後腸阻塞是且支部手術常見的併發症,為了減少腸阻塞持續時間,臨床醫療有若不同的照護措施, 如採較不具使入性的改腔鏡手術、硬膜外麻醉、早期下床及進食等,而咀嚼口香糖是一種模擬食物攝入 的假性進食,是刺激腸埔動功能的替代方法。本文進行統合分析以確定咀嚼口香梅對結腸切除術後患者 排氣、排便及住院時間之成效。文獻搜尋2014年6月以前中、英文文獻,五個資料庫包括PubMed 、Cochrane, Medline 、CINAHL及華藝線上圖書館。進行結腸切除術後咀嚼口香糖之隨機控制試驗,並以Jadad Scale 作為篩選文章品質工具。使用Review Manager 5.1 版軟體進行統合分析,並以加權平均差及95%信賴區間 呈現。共得6篇隨機臨床試驗,包含312位研究對象。研究結呆顯示,咀嚼口香糖封給腸切除術後患者能 顯著縮短排氣、排便時間,其總效益值依序為- 12.45 小時(95%CI: -22.53, -2.38, P=.02)及- 16.15 小時(95% CI: -25.36, -6.94, p<0.001),而對縮短住院時間亦有成效,總效益值為-2.44 天(95% CI: -3.10, -1.77, p<0.001 ) 。 本研究提供較客觀之統合分析結果,可作為臨床醫護人員臨床應用之參考依據,而未來仍需繼續進行嚴 謹、大規模、盲化的隨機對照試驗並更新統合結果。

英文摘要

Postoperative ileus is a common complication after abdominal surgery. Various surgical teclmiques and perioperative approaches such as using of laparoscopic procedures, epidural analgesia, early mobilization and early feeding have been shown to facilitated recovery from ileus. Chewing gum is a form of sham feeding that stimulates bowel motility. The study conducted a meta-analysis to summarize the effect of chewing gum in reducing time to flatus, time to bowel movement, and length of hospital stay. The literature search focused on articles published before May 2014, and the following databases were searched: PubMed, Cochrane Library, MEDLINE, CINAHL, and Airiti Library. We aimed to identify all randomized controlled trials (RCTs) comparing with and without the use of chewing gum in patients after colorectal surgery. Study quality was assessed using J adad scale. Statistical analyses were performed using Review Manager, version 5 .1 and weighted mean difference (WMD) with 95% confidence intervals. Six RCTs with 312 patients were included. The results showed that chewing gum was effective on reducing in time to flatus by 12.45 hr (95% CI: -22.53 to -2.38, p=0.02), and time to bowel movement by 16.15 hr (95% CI: -25.36 to -6.94, p<0.001). Length of hospital stay was also reduced in the treatment group by 2.44 d (95% CI: -3.10 to 1.77, p<0.001). The research provided objective and synthetic results to encourage clinical staff using them as the reference basis for application. More large size, blinded RCTs are warranted in the future.

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