嚼口香糖促进结肠手术康复
Chew Gum for Colon Surgery RecoveryResearchers Say Gum Chewing Speeds Recovery From Surgery and Cuts Health Care Spending
By Salynn Boyles
WebMD Health News
Reviewed by Louise Chang, MD
Aug. 18, 2008 -- Simply chewing gum after colon surgery can reduce recovery time and shorten hospital stays, a review of research shows.
It could also save more than $100 million in health care spending annually, according to findings from one study.
In the U.S. alone, postoperative ileus -- the medical term for the inability of the bowels to function normally following surgery -- has been estimated to cost the health care system up to $1 billion each year.
\"Postoperative ileus remains the single greatest barrier to discharge in otherwise uncomplicated colorectal surgery,\" colorectal surgeon Joshua Katz, MD, tells WebMD. \"If this relatively easy, safe and cheap intervention can help, it is certainly something worth trying.\"
Gum Chewing May Speed Recovery
The newly published analysis included five studies reported since July 2006 involving a total of 158 patients.
Gum chewing was found to speed up the time it took the intestines to begin working again after surgical removal of all or part of the colon.
In each of the studies, some patients chewed no gum and others chewed sugarless gum three times a day after surgery for five to 45 minutes.
When the all study results were analyzed together, the patients who didn't chew gum were found to have taken an average of two-thirds of a day longer to pass gas and just over one day longer than the chewers to have a bowel movement -- both signs of intestinal recovery.
In the four studies that assessed length of hospital stay, the gum chewers were discharged, on average, about a day earlier, although this was not statistically significant.
Researcher Sanjay Purkayastha, BSc and colleagues from St. Mary's Hospital in London, hypothesize that gum chewing stimulates bowel recovery in the same way that eating does, by triggering the release of gastrointestinal hormones and increasing the production of saliva and secretions from the pancreas.
Their analysis appears in the August issue of Archives of Surgery.
\"We feel that the current evidence suggests that gum chewing following abdominal surgery offers significant benefits in reducing the time to resolution of ileus; however, the studies are insufficiently powered to identify a significant benefit in length of stay.\"
Colon Surgery and Hospital Stays
The researchers call for larger, randomized studies designed specifically to show that postsurgical gum chewing reduces hospital stays following abdominal surgery.
In a 2006 study, which was included in the analysis, researchers from Santa Barbara Cottage Hospital estimated that adding postsurgical gum chewing to the colon surgery regimen could save $118 million a year in the U.S.
In this small study, involving 17 patients who chewed gum and 17 others who didn't, the average hospital stay was 4.3 days for gum chewers -- 2.5 days less than for the patients who did not chew gum.
Katz tells WebMD that the typical length of a hospital stay is around five days following colon surgery. The director of colorectal surgery for Montgomery Surgery Center in Rockville, Md., Katz says gum chewing may have a slight impact on this, but not a huge one.
\"This doesn't mean that if you give someone chewing gum they will just jump out of bed and feel good enough to go home,\" he says. \"This is major surgery.\"
But the surgery has also changed drastically over the last decade, and those changes have resulted in average hospital stays that are half as long as they once were, he says.
\"Chewing gum is just one piece of the puzzle,\" he says.
编译：
嚼口香糖促进结肠手术康复
研究者们指出：“嚼口香糖能够加速手术康复以及减少医疗花费。”
来自WebMD 健康新闻Salynn Boyles的报道，由Louise Chang MD综述
2008年8月18日，研究表明，结肠手术后嚼口香糖可以减少恢复时间和缩短住院天数。
根据其中的一项研究结果显示：每年还可以减少医疗花费超过100万美元。
在美国，每年仅仅是手术后肠梗阻至肠功能恢复期间的医疗费用达到10亿美元。
结直肠外科医生Joshua Katz, MD,告诉WebMD的记者：“无并发症的结直肠手术后肠梗阻仍然是造成患者术后出院的唯一的最大的障碍。”
最新出版的分析包括2006年7月报导的5项研究，病例数共为158例患者。
研究发现嚼口香糖能够加速全结肠切除或者是部分结肠切除术后肠道功能恢复的时间。
在每一项研究中，一部分患者不嚼口香糖与另一部分患者一天嚼三次口香糖，每次嚼5到45分钟。
所有的研究结果集中在一起分析，不嚼口香糖的患者要比嚼口香糖的患者肠道通气时间平均长2/3天，肠蠕动时间平均长一天。以上两项体征均为肠功能恢复的标志。
在其中的四项研究中，嚼口香糖的患者的出院时间平均短一天，虽然这项数据没有显著的统计学意义。
伦敦圣.玛丽医院的Sanjay Purkayastha，BSc研究员和同事们猜测：在饮食方式相同的情况下，嚼口香糖能够通过诱导胃肠道激素分泌以及增加唾液和胰腺分泌物的产生来刺激肠道功能康复。
《外科学纪要》第8期上刊登了他们的研究结果。
“我们觉得目前的证据表明腹部手术后嚼口香糖对减少解决术后肠梗阻的时间有显著的意义。然而，研究并没有提供足够的证据证明嚼口香糖对住院时间上有明显的好处。”
结肠手术与住院时间
研究者们提议设计特定的大规模的随机研究证明术后嚼口香糖能够减少腹部手术后的时间。
根据2006年的一项研究分析的结果，来自圣巴巴拉诊疗所的研究员估计在美国结肠手术后食疗加上嚼口香糖可能每年节省118000000万美元。
这项小规模的研究包括17名嚼口香糖的患者与17名不嚼口香糖的患者对照，前者的术后平均住院时间为4.3天，比后者少2.5天；
洛克维尔的蒙哥马利手术中心的结直肠外科主任Katz，MD告诉WebMD的记者，通常结肠手术后的住院天数大约5天，嚼口香糖可能对此有较小的影响，但不是很明显。
他说：“这并不意味着如果你给让一些患者嚼口香糖，他就会马上从床上蹦起来，感觉完全康复可以回家了。主要还是要看手术本身。”
他说：“但是在过去的十年里，手术已经造成了一些显著变化，这些变化包括平均住院天数比以前缩短了一半。”
他说：“嚼口香糖仅仅是一个难题。”
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