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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<0.00001],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。
Objective To evaluate the effectiveness and safety of chewing gum after caesarean operation in promoting the recovery of intestinal function. Methods The Cochrane Library, MEDLINE, EMbase and China Biomedical Literature Database were searched by computer. The search time was from database construction to 2010, and included randomized controlled trials comparing the chewing gum after cesarean section with other treatments to promote the recovery of intestinal function. After inclusion of the study’s risk of bias for assessment, RevMan 5.0.22 software was used for meta-analysis. Results A total of 3 randomized controlled trials were included, with a total of 745 patients. Meta-analysis showed that chewing gum after cesarean section could shorten the time of the first anal exhaust after the operation [MD = -6.54,95% CI (-7.82, -5.27), P <0.00001] and reduce postoperative intestinal obstruction (RR = 0.54, 95% CI (0.34, 0.87), P = .01], potentially reducing hospital stays [MD = -0.21,95% CI (-0.39, -0.03), P = .02]. There is currently insufficient data to support the safety of chewing gum after caesarean section. Conclusion Chewing gum after cesarean section can promote the recovery of postoperative gastrointestinal function and reduce the occurrence of postoperative intestinal obstruction. However, due to the small number of included studies and poor methodology, more high-quality research is still needed to increase the strength of the argument.