比較嚼口香糖與早期飲水對婦科良性腫瘤術後病人之排氣成效

To Explore the Impact of Different Methods on Gastrointestinal Function of Women Who Had Benign Gynecological Surgery: A Quasi-Experimental Study

郭素真(Shu-Chen Kuo) ； 沈華詩(Hua-Shih Shen) ； 石琮瑛(Tsung-Ying Shih) ； 柯莉珊(Li-Shan Ke) ； 洪雯玲(Wen-Ling Hung) ； 周幸生(Shin-Shang Chou)

《榮總護理》 30卷2期 (2013/06) Pp. 181-190

https://doi.org/10.6142/VGHN.30.2.181

摘要

The aim of this study was to investigate the effect of gastrointestinal function recovery of chewing gum and early drinking by using quasi-experimental study. 103 patients were enrolled to three groups: 30 in gum-chewing group, 38 in drinking water group, and 35 in nothing-by-mouth group until flatus between September 2011 to February 2012. We found the primary outcomes, including the time period till first flatus, the time period till first passage of stool and the time period till first bowel movement through self-report were not statistically significant. The secondary outcomes we detected were length of hospital stay and complications of postoperative ileus, including nausea and vomit times. The length of hospital stay was statistically significant, the chewing gum group being the shortest, the drinking water group coming in second, and the fasting group with the longest length of stay. We found that chewing and drinking water didn't increase the incidence of ileus symptoms. Meanwhile, the gum-chewing group showed a decrease in vomit times compared to the fasting group. This study shows that after benign gynecological tumor surgery under general anesthesia, women used chewing gum or early drinking water are safe and effective interventions. We suggest that the two interventions could be used broadly in department of obstetrics and gynecology or others to improve the quality of surgical patient care.

關鍵字

婦科良性腫瘤手術 ； 口香糖 ； 早期飲水 ； 類實驗研究

並列摘要

The aim of this study was to investigate the effect of gastrointestinal function recovery of chewing gum and early drinking by using quasi-experimental study. 103 patients were enrolled to three groups: 30 in gum-chewing group, 38 in drinking water group, and 35 in nothing-by-mouth group until flatus between September 2011 to February 2012. We found the primary outcomes, including the time period till first flatus, the time period till first passage of stool and the time period till first bowel movement through self-report were not statistically significant. The secondary outcomes we detected were length of hospital stay and complications of postoperative ileus, including nausea and vomit times. The length of hospital stay was statistically significant, the chewing gum group being the shortest, the drinking water group coming in second, and the fasting group with the longest length of stay. We found that chewing and drinking water didn't increase the incidence of ileus symptoms. Meanwhile, the gum-chewing group showed a decrease in vomit times compared to the fasting group. This study shows that after benign gynecological tumor surgery under general anesthesia, women used chewing gum or early drinking water are safe and effective interventions. We suggest that the two interventions could be used broadly in department of obstetrics and gynecology or others to improve the quality of surgical patient care.

並列關鍵字

benign gynecological surgery ； quasi-experimental study ； chewing gum ； drinking water

參考文獻

Abd-EI-Maeboud, K. H. I., Ibrahim, M. I., Shalaby, D. A. A., & Fikry, M. F. (2009).Gum chewing stimulates early return of bowel motility after caesarean section. BJOG: An International Journal of Obstetrics and Gynaecology, 116(10), 1334-1339. doi: 10.1111/j.1471-0528.2009.02225.x

Asao, T., Kuwano, H., Nakamura, J.I., Morinaga, N., Hirayama, I., & Ide, M. (2002). Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Journal of American College of Surgeons, 195(1), 30–32. doi: 10.1016/ S1072-7515(02)01179-1

Charoenkwan, K., Phillipson, G., & Vutyavanich, T., (2007). Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery. Cochrane Database Systematic Review(4), CD004508. doi: 10.1002/14651858. CD004508.pub3.

Fanning, J., & Valea, F. A. (2011). Perioperative bowel management for gynecologic surgery. American Journal of Obstetrics & Gynecology, 205(4), 309-314. doi:10.1016/ j.ajog.2011.05.010

Fitzgerald, J. E., & Ahmed, I. (2009). Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World Journal of Surgery, 33(12), 2557-2566. doi: 10.1007/s00268-009- 0104-5