目錄1 前言 42 國內(nèi)外研究現(xiàn)狀 42.1 國外研究現(xiàn)狀 42.2 國內(nèi)研究現(xiàn)狀 53 咀嚼口香糖促進(jìn)胃腸功能恢復(fù)的作用機(jī)制 64 咀嚼口香糖促進(jìn)胃腸功能恢復(fù)的臨床應(yīng)用效果 74.1 在結(jié)直腸手術(shù)中的應(yīng)用 74.2 在腹腔鏡膽囊切除術(shù)中的應(yīng)用 74.3 在剖宮產(chǎn)手術(shù)中的應(yīng)用 84.4 在其他腹部手術(shù)中的應(yīng)用 85 討論 96 結(jié)論 9中文摘要腹部手術(shù)后常因禁食禁水、麻醉等各方面原因?qū)е禄颊咝g(shù)后胃腸功能障礙以及情緒的變化，會(huì)使患者推遲出院時(shí)間以及經(jīng)濟(jì)負(fù)荷加重。正因如此術(shù)后促進(jìn)胃腸功能恢復(fù)就成為了腹部手術(shù)后的關(guān)鍵環(huán)節(jié)，對(duì)患者術(shù)后的康復(fù)速度多有影響。加速康復(fù)外科理念的提出是為了通過多種模式來促進(jìn)病人在治療期間生理與心理的康復(fù)。咀嚼口香糖作為一種只有咀嚼行為并沒有經(jīng)口進(jìn)食的方式，使患者的發(fā)生反射而不造成其傷害，極大的幫助了患者腹部術(shù)后胃腸功能的更快康復(fù)，且沒有副作用。從而使咀嚼口香糖作為一種簡單、經(jīng)濟(jì)、安全的非藥物干預(yù)措施，被廣泛應(yīng)用于腹部手術(shù)后促進(jìn)胃腸功能的加速恢復(fù)的護(hù)理之中。它可以更快的減輕患者的經(jīng)濟(jì)壓力、減輕患者的身體負(fù)擔(dān)、使患者舒適度提升等。本文旨在描述咀嚼口香糖對(duì)腹部手術(shù)后病人胃腸功能恢復(fù)的生理機(jī)制及臨床應(yīng)用的效果，并對(duì)未來的臨床研究提出建議及作出展望。關(guān)鍵詞：腹部手術(shù)/咀嚼口香糖/假飼

AbstractAfterabdominalsurgery,patientsoftensufferfromgastrointestinaldysfunctionandemotionalchangesduetofasting,water,anesthesiaandotherreasons,whichwilldelaythedischargetimeandincreasetheeconomicburdenofpatients.Therefore,promotingtherecoveryofgastrointestinalfunctionaftersurgeryhasbecomeakeylinkafterabdominalsurgery,whichhasalotofimpactontherecoveryspeedofpatientsaftersurgery.Theconceptofacceleratedrecoverysurgerywasproposedtopromotethephysicalandpsychologicalrecoveryofpatientsduringtreatmentthroughavarietyofmodalities.Chewinggum,asawayofchewingandnoteatingbymouth,makesthepatient'sbodyreflexwithoutcausingharm,whichgreatlyhelpsthepatient'sgastrointestinalfunctiontorecoverfasterafterabdominalsurgerywithoutsideeffects.Asaresult,chewinggumiswidelyusedasasimple,economical,andsafenon-pharmacologicalinterventiontopromoteacceleratedrecoveryofgastrointestinalfunctionafterabdominalsurgery.Itcanreducethepatient'sfinancialpressurefaster,reducethepatient'sphysicalburden,andimprovethepatient'scomfort.Thepurposeofthisarticleistodescribethephysiologicalmechanismandclinicalapplicationofchewinggumontherecoveryofgastrointestinalfunctioninpatientsafterabdominalsurgery,andtomakesuggestionsandprospectsforfutureclinicalresearch.KeyWords:Abdominalsurgery/gumchewing/fakefeeding

咀嚼口香糖對(duì)腹部手術(shù)后病人胃腸功能恢復(fù)的應(yīng)用效果研究進(jìn)展前言腹部圍手術(shù)期間，ADDINEN.CITE<EndNote><Cite><Author>沈俏微</Author><Year>2019</Year><RecNum>14</RecNum><DisplayText><styleface="superscript">[1]</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741872144">14</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>沈俏微</author><author>徐學(xué)軍</author><author>李玲</author></authors></contributors><auth-address>浙江中醫(yī)藥大學(xué)護(hù)理學(xué)院;浙江省寧波市婦女兒童醫(yī)院手術(shù)室;</auth-address><titles><title>宮頸癌3D腹腔鏡手術(shù)患者手術(shù)室內(nèi)采用針對(duì)性護(hù)理對(duì)預(yù)防應(yīng)激反應(yīng)寒戰(zhàn)的價(jià)值</title><secondary-title>中國藥物與臨床</secondary-title></titles><periodical><full-title>中國藥物與臨床</full-title></periodical><pages>2676-2678</pages><volume>19</volume><number>15</number><dates><year>2019</year></dates><isbn>1671-2560</isbn><call-num>11-4706/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=LY1OVaQjltzE3Z1txWoSliebeIllBLBwkXG_zDywOFyYU9DNeCsk87g6QikiZDMuT3ApDzd5dxuml2SlEEe5DOwly7eKCopjTUm7pg27v8n5XXwiXk6d439cxzxIU4cM7I-NWBaf36GzeICv0NDxrZ916wAtc8ShK1WJltC0X2vTANyI2HcZiI1ks-SMaWNJPrysyh6yYzY=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[1]患者常常因?yàn)槭中g(shù)產(chǎn)生的應(yīng)激反應(yīng)出現(xiàn)術(shù)后胃腸功能障礙，不僅影響患者的生理狀態(tài)也對(duì)其心理產(chǎn)生消極的影響。在手術(shù)前常規(guī)的禁食禁水護(hù)理也會(huì)導(dǎo)致迷走神經(jīng)的興奮性降低以及手術(shù)產(chǎn)生的應(yīng)激也可能提高交感神經(jīng)的興奮性導(dǎo)致術(shù)后疼痛加劇，甚至需要加用鎮(zhèn)痛藥物。這些原因都對(duì)患者的早期機(jī)體的康復(fù)沒有幫助ADDINEN.CITE<EndNote><Cite><Author>陳慧穎</Author><Year>2020</Year><RecNum>15</RecNum><DisplayText><styleface="superscript">[2]</style></DisplayText><record><rec-number>15</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741872218">15</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>陳慧穎</author><author>孫穎</author><author>劉付懿斐</author></authors></contributors><auth-address>廣州中醫(yī)藥大學(xué);廣州中醫(yī)藥大學(xué)深圳醫(yī)院;</auth-address><titles><title>扶正通腑導(dǎo)滯法聯(lián)合電針治療腹腔鏡術(shù)后胃腸功能紊亂療效觀察</title><secondary-title>現(xiàn)代中西醫(yī)結(jié)合雜志</secondary-title></titles><periodical><full-title>現(xiàn)代中西醫(yī)結(jié)合雜志</full-title></periodical><pages>59-62</pages><volume>29</volume><number>01</number><keywords><keyword>扶正通腑導(dǎo)滯法</keyword><keyword>電針陽明經(jīng)穴</keyword><keyword>腹腔鏡手術(shù)</keyword><keyword>胃腸功能</keyword></keywords><dates><year>2020</year></dates><isbn>1008-8849</isbn><call-num>13-1283/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=LY1OVaQjltyC6BpxFesJoWS21PamcIELALEqX08S-jmEfJdJzBJHVsLn7hg1J_e1t088TAxuUFeqWaoQP4YpXgoOZoDbO_SaWWnriSKJbw4n4rPO0NqFnMYGsSjwNfHJWO7n_K6QQloh4qDcX4-hhUaeZngdOjag_Cl-ZB03-aYiYx-UmAUT7goymS0R-f307TFSea6Vdr0=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[2]。咀嚼口香糖作為一種加速患者機(jī)體康復(fù)的方法，張哲等學(xué)者的分析可以看出ADDINEN.CITE<EndNote><Cite><Author>張哲</Author><Year>2020</Year><RecNum>16</RecNum><DisplayText><styleface="superscript">[3]</style></DisplayText><record><rec-number>16</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741872292">16</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>張哲</author><author>付雯</author><author>謝鑫</author><author>雷梟</author><author>陳艷</author><author>劉慧</author></authors></contributors><auth-address>川北醫(yī)學(xué)院;川北醫(yī)學(xué)院附屬醫(yī)院中醫(yī)科;</auth-address><titles><title>咀嚼口香糖對(duì)剖宮產(chǎn)術(shù)后患者胃腸功能影響的Meta分析</title><secondary-title>海南醫(yī)學(xué)</secondary-title></titles><periodical><full-title>海南醫(yī)學(xué)</full-title></periodical><pages>930-936</pages><volume>31</volume><number>07</number><keywords><keyword>咀嚼口香糖</keyword><keyword>剖宮產(chǎn)術(shù)后</keyword><keyword>胃腸功能恢復(fù)</keyword><keyword>Meta分析</keyword></keywords><dates><year>2020</year></dates><isbn>1003-6350</isbn><call-num>46-1025/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=LY1OVaQjltxdPK9Jv5FdqlMyHvE95sArnvbLGd_osMD2IxvGxCqfQ6_T9muMg0JNOp4pyY0CJ9QwXRWnP1l5lKTCR2jag4Z1Z0_w8TlIJYVZC9ri8fLLkRZnjX55ooZXaPZajfve6P8T4rwb4mjZlg9t8Xbnst428xIcSenUDYIixRTwdo1jUr4GNrdYoYHdl4XhgGyQsnM=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[3]，咀嚼口香糖在促進(jìn)腹部手術(shù)后胃腸功能恢復(fù)具有積極的影響。本綜述旨在討論咀嚼口香糖對(duì)腹部手術(shù)患者能否促進(jìn)其胃腸功能早期恢復(fù)，總結(jié)出非藥物干預(yù)措施的作用機(jī)制、臨床應(yīng)用以及局限性和未來的挑戰(zhàn)。國內(nèi)外研究現(xiàn)狀國外研究現(xiàn)狀加速康復(fù)外科理念（ERAS）是于20世紀(jì)90年代由丹麥Kehlet教授ADDINEN.CITE<EndNote><Cite><Author>中國加速康復(fù)外科專家組</Author><Year>2016</Year><RecNum>41</RecNum><DisplayText><styleface="superscript">[4]</style></DisplayText><record><rec-number>41</rec-number><foreign-keys><keyapp="EN"db-id="2ff9ttv9fxvzeye2af85xdxodz5wtttfs90z"timestamp="1741694798">41</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>中國加速康復(fù)外科專家組</author></authors></contributors><titles><title>中國加速康復(fù)外科圍術(shù)期管理專家共識(shí)(2016版)</title><secondary-title>中華消化外科雜志</secondary-title></titles><periodical><full-title>中華消化外科雜志</full-title></periodical><pages>527-533</pages><volume>15</volume><number>06</number><keywords><keyword>外科疾病</keyword><keyword>加速康復(fù)外科</keyword><keyword>共識(shí)</keyword></keywords><dates><year>2016</year></dates><isbn>1673-9752</isbn><call-num>11-5610/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=DnpHqYycDUMQmasyrpT6WKFiHmUY1daQ8pyNHVn4VVIEX7K_Sd-eJ_aM4HTlOydSv3IQWozTZagvJXx0-E8OU6hZmG1cfMTN4HF5JGVyTEOZnss2KCBmxIq0M29U1H0hoZjy0_SmfQTe-i1582jkNkpCElDBhm8aXwvRUkyD6_qn2ffoR-Z_TEKcxQ2_4Q49&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[4]提出，通過ERAS協(xié)會(huì)不斷改進(jìn)與優(yōu)化。是以多種學(xué)科、多種模式去減輕患者在身體機(jī)能恢復(fù)時(shí)期的應(yīng)激反應(yīng)。最終就是為了使患者安穩(wěn)的度過治療期并促進(jìn)患者生理心理的康復(fù)。此理念在腹部手術(shù)中應(yīng)用較為成功。術(shù)后胃腸功能障礙（postoperativegastrointestinaldysfunction,POGD）又稱為術(shù)后胃腸功能紊亂，它是治療期間的各種原因使得術(shù)后胃腸功能恢復(fù)延遲或停止的臨床表現(xiàn)的總稱。表現(xiàn)為手術(shù)后患者發(fā)生胃脹、惡心、排氣時(shí)間延長等，甚至發(fā)生腸道梗阻。國外的研究數(shù)據(jù)ADDINEN.CITEADDINEN.CITE.DATA[5]可以看出，術(shù)前空腹時(shí)咀嚼口香糖可以緩解術(shù)前焦慮并提高患者術(shù)后的恢復(fù)質(zhì)量，并且不會(huì)增加術(shù)后患者的誤吸風(fēng)險(xiǎn)。ADDINEN.CITEADDINEN.CITE.DATA[6]據(jù)統(tǒng)計(jì)，在腹部手術(shù)后胃腸功能障礙的發(fā)生率高達(dá)48%，而通過咀嚼口香糖進(jìn)行干預(yù)后這一比例可降至27%。結(jié)果表示，咀嚼口香糖作為一種“假飼”手段通過模擬進(jìn)食的生理效應(yīng)安全有效地促進(jìn)胃腸功能的恢復(fù)。并且有研究表明ADDINEN.CITEADDINEN.CITE.DATA[7]咀嚼口香糖可以完全緩解術(shù)后惡心嘔吐。在與傳統(tǒng)的早期腸內(nèi)營養(yǎng)相比，咀嚼口香糖具有操作簡便、無創(chuàng)且成本低廉的優(yōu)勢被視為一種更安全、更易推廣的術(shù)后康復(fù)干預(yù)措施。國內(nèi)研究現(xiàn)狀國內(nèi)學(xué)者指出ADDINEN.CITE<EndNote><Cite><Author>付紅萍</Author><Year>2017</Year><RecNum>11</RecNum><DisplayText><styleface="superscript">[8]</style></DisplayText><record><rec-number>11</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741869327">11</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>付紅萍</author></authors></contributors><auth-address>江西省腫瘤醫(yī)院綜合科;</auth-address><titles><title>咀嚼口香糖對(duì)胃癌術(shù)后患者胃腸功能恢復(fù)的影響</title><secondary-title>護(hù)理實(shí)踐與研究</secondary-title></titles><periodical><full-title>護(hù)理實(shí)踐與研究</full-title></periodical><pages>88-89</pages><volume>14</volume><number>06</number><keywords><keyword>胃癌術(shù)后</keyword><keyword>口香糖</keyword><keyword>肛門排便排氣時(shí)間</keyword></keywords><dates><year>2017</year></dates><isbn>1672-9676</isbn><call-num>13-1352/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=LY1OVaQjltzsUsTJgIumsKJ4PqelI62zl-xBjvCWkE7EtM2gM-yBuPzB8croqobsV8s3z5GTG1hGPQBeXAJH_0wI3oo96UUN35rz15WD0GqT0IEmG4Jk5LHTUtaTT2_PQSU_7tWIH0ze9BoysM-MQXKHMoUf5bQVlp1E8gjnwQzUoC1jtQfMvdcRsSh-sYNnKhZ0gnlm1mc=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[8]胃腸功能障礙發(fā)病原因多又復(fù)雜。其與腹部手術(shù)前長時(shí)間的禁食禁飲、術(shù)中使用麻醉、手術(shù)創(chuàng)傷以及術(shù)后活動(dòng)減少、不能適應(yīng)床上排便有極大的相關(guān)性。ADDINEN.CITE<EndNote><Cite><Author>Ge</Author><Year>2015</Year><RecNum>2</RecNum><DisplayText><styleface="superscript">[9]</style></DisplayText><record><rec-number>2</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741606306">2</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Ge,W.</author><author>Chen,G.</author><author>Ding,Y.T.</author></authors></contributors><auth-address>DepartmentofGeneralSurgery,NanjingDrumTowerHospital,TheAffiliatedHospitalofNanjingUniversityMedicalSchoolNanjing210008,JiangsuProvince,P.R.China.</auth-address><titles><title>Effectofchewinggumonthepostoperativerecoveryofgastrointestinalfunction</title><secondary-title>IntJClinExpMed</secondary-title></titles><periodical><full-title>IntJClinExpMed</full-title></periodical><pages>11936-42</pages><volume>8</volume><number>8</number><edition>20150815</edition><keywords><keyword>Chewinggum</keyword><keyword>Rct</keyword><keyword>gastrointestinalfunction</keyword><keyword>postoperativeileu</keyword></keywords><dates><year>2015</year></dates><isbn>1940-5901(Print) 1940-5901</isbn><accession-num>26550107</accession-num><urls></urls><custom2>PMC4612792</custom2><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[9]患者術(shù)后胃腸功能障礙的發(fā)生會(huì)影響患者生活質(zhì)量以及使感染的風(fēng)險(xiǎn)增加。也有可能會(huì)引起焦慮、情緒暴躁等消極情緒ADDINEN.CITE<EndNote><Cite><Author>肖閃閃</Author><Year>2024</Year><RecNum>4</RecNum><DisplayText><styleface="superscript">[10]</style></DisplayText><record><rec-number>4</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741610219">4</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>肖閃閃</author><author>黃麗珊</author><author>王琳</author><author>許燕昕</author></authors></contributors><auth-address>廣東省第二人民醫(yī)院;廣東藥科大學(xué)護(hù)理學(xué)院;</auth-address><titles><title>腹部穴位按摩聯(lián)合咀嚼口香糖在預(yù)防后路腰椎椎間融合術(shù)后患者便秘中的應(yīng)用</title><secondary-title>齊魯護(hù)理雜志</secondary-title></titles><periodical><full-title>齊魯護(hù)理雜志</full-title></periodical><pages>121-123</pages><volume>30</volume><number>20</number><keywords><keyword>腹部穴位按摩</keyword><keyword>咀嚼口香糖</keyword><keyword>腰椎術(shù)后</keyword><keyword>便秘</keyword></keywords><dates><year>2024</year></dates><isbn>1006-7256</isbn><call-num>37-1257/R</call-num><urls><related-urls><url>/kcms2/article/abstract?v=DnpHqYycDUO82YKYpFNaMpinU3FSMw1ivbP6q6KKO7XpTsEWfHhxrNSDxB2Z1P388RhSXFEWzzCaKg3HdMzMtI3qecGL96fho6sGQtFkjMkPnmFZ641aSc5zlDiVxQyszOmBkUGoNc1DV_gDP2lpovQJtTzA16qovf_GNHksr8Kr5btfCrPbqHfahDesbEjKD7yoEaQpRkk=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[10]。靜脈補(bǔ)充液體、插鼻胃管、調(diào)節(jié)體內(nèi)酸堿平衡、做好手術(shù)后床邊護(hù)理、藥物促進(jìn)胃腸動(dòng)力、早期下床活動(dòng)等ADDINEN.CITE<EndNote><Cite><Author>Nanthiphatthanachai</Author><Year>2020</Year><RecNum>155</RecNum><DisplayText><styleface="superscript">[11]</style></DisplayText><record><rec-number>155</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1742548880">155</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Nanthiphatthanachai,A.</author><author>Insin,P.</author></authors></contributors><auth-address>DepartmentofObstetricsandGynecology,RajavithiHospital,Bangkok,Thailand. CollegeofMedicine,RangsitUniversity,Bangkok,Thailand.</auth-address><titles><title>EffectofChewingGumonGastrointestinalFunctionRecoveryAfterSurgeryofGynecologicalCancerPatientsatRajavithiHospital:ARandomizedControlledTrial</title><secondary-title>AsianPacJCancerPrev</secondary-title></titles><periodical><full-title>AsianPacJCancerPrev</full-title></periodical><pages>761-770</pages><volume>21</volume><number>3</number><edition>20200301</edition><keywords><keyword>Adult</keyword><keyword>*ChewingGum</keyword><keyword>Female</keyword><keyword>GynecologicSurgicalProcedures</keyword><keyword>Hospitals</keyword><keyword>Humans</keyword><keyword>MiddleAged</keyword><keyword>RecoveryofFunction</keyword><keyword>*UrogenitalNeoplasms/surgery</keyword><keyword>UterineNeoplasms</keyword><keyword>Gum-chewing</keyword><keyword>gastrointestinalfunctionrecovery</keyword><keyword>gynecologicalcancersurgery</keyword><keyword>postoperativebowelileus</keyword></keywords><dates><year>2020</year><pub-dates><date>Mar1</date></pub-dates></dates><isbn>1513-7368(Print) 1513-7368</isbn><accession-num>32212805</accession-num><urls></urls><custom2>PMC7437335</custom2><electronic-resource-num>10.31557/apjcp.2061</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[11]等傳統(tǒng)的治療干預(yù)手段緩解術(shù)后胃腸功能障礙效果不顯著。使患者的生理恢復(fù)速度延緩并且對(duì)患者的心理狀態(tài)造成消極影響，術(shù)后焦慮和抑郁的潛在發(fā)生性也極大提高。林渲果等學(xué)者ADDINEN.CITE<EndNote><Cite><Author>林渲果</Author><Year>2020</Year><RecNum>9</RecNum><DisplayText><styleface="superscript">[12]</style></DisplayText><record><rec-number>9</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1741785824">9</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>林渲果</author><author>林媛</author><author>辜晶榮</author><author>文紅梅</author></authors></contributors><auth-address>廣西壯族自治區(qū)南溪山醫(yī)院胃腸外科;</auth-address><titles><title>咀嚼口香糖聯(lián)合加速康復(fù)外科對(duì)胃癌患者術(shù)后腸功能恢復(fù)的影響</title><secondary-title>當(dāng)代護(hù)士(中旬刊)</secondary-title></titles><periodical><full-title>當(dāng)代護(hù)士(中旬刊)</full-title></periodical><pages>75-77</pages><volume>27</volume><number>06</number><keywords><keyword>胃癌術(shù)后</keyword><keyword>腸功能</keyword><keyword>咀嚼口香糖</keyword><keyword>加速康復(fù)外科</keyword></keywords><dates><year>2020</year></dates><isbn>1006-6411</isbn><call-num>43-1229/R</call-num><urls><related-urls><url>/doi/10.19792/ki.1006-6411.2020.17.033</url></related-urls></urls><electronic-resource-num>10.19792/ki.1006-6411.2020.17.033</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[12]的研究表明咀嚼口香糖能讓患者術(shù)后首次排氣和排便時(shí)間平均縮短12.5小時(shí)。這種非藥物治療的干預(yù)可以促進(jìn)胃腸功能的復(fù)原、使患者盡快出院并且可以減輕患者的經(jīng)濟(jì)負(fù)擔(dān)和心理壓力。ADDINEN.CITE<EndNote><Cite><Author>哈博文</Author><Year>2022</Year><RecNum>22</RecNum><DisplayText><styleface="superscript">[13]</style></DisplayText><record><rec-number>22</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1745322422">22</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>哈博文</author><author>王騰祺</author></authors></contributors><auth-address>內(nèi)蒙古醫(yī)科大學(xué);巴彥淖爾市醫(yī)院胃腸外科;</auth-address><titles><title>基于加速康復(fù)外科的非藥物干預(yù)促進(jìn)結(jié)直腸癌患者術(shù)后胃腸功能恢復(fù)的應(yīng)用進(jìn)展</title><secondary-title>內(nèi)蒙古醫(yī)學(xué)雜志</secondary-title></titles><periodical><full-title>內(nèi)蒙古醫(yī)學(xué)雜志</full-title></periodical><pages>1073-1076+1081</pages><volume>54</volume><number>09</number><keywords><keyword>結(jié)直腸腫瘤</keyword><keyword>腸</keyword><keyword>功能恢復(fù)</keyword></keywords><dates><year>2022</year></dates><isbn>1004-0951</isbn><call-num>15-1108/R</call-num><urls><related-urls><url>/doi/10.16096/J.cnki.nmgyxzz.2022.54.09.013</url></related-urls></urls><electronic-resource-num>10.16096/J.cnki.nmgyxzz.2022.54.09.013</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[13]研究還能看出，咀嚼口香糖能有效減少術(shù)后惡心嘔吐、胃潴留與肺部感染等并發(fā)癥的發(fā)生，進(jìn)一步提升患者的康復(fù)的質(zhì)量。加快術(shù)后胃腸功能的恢復(fù)已經(jīng)成為加速患者機(jī)體和心理康復(fù)的關(guān)鍵環(huán)節(jié)。也有研究表明ADDINEN.CITE<EndNote><Cite><Author>吳艷麗</Author><Year>2017</Year><RecNum>59</RecNum><DisplayText><styleface="superscript">[14]</style></DisplayText><record><rec-number>59</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1732109852">59</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>吳艷麗</author><author>孔憲超</author></authors></contributors><auth-address>哈爾濱醫(yī)科大學(xué)附屬第二醫(yī)院婦產(chǎn)科;</auth-address><titles><title>咀嚼口香糖對(duì)婦科腹腔鏡術(shù)后胃腸功能恢復(fù)的影響</title><secondary-title>中國婦產(chǎn)科臨床雜志</secondary-title></titles><periodical><full-title>中國婦產(chǎn)科臨床雜志</full-title></periodical><pages>184-186</pages><volume>18</volume><number>02</number><keywords><keyword>婦科腹腔鏡手術(shù)</keyword><keyword>咀嚼口香糖</keyword><keyword>胃腸功能恢復(fù)</keyword></keywords><dates><year>2017</year></dates><isbn>1672-1861</isbn><call-num>11-4967/R</call-num><urls><related-urls><url>/doi/10.13390/j.issn.1672-1861.2017.02.030</url></related-urls></urls><electronic-resource-num>10.13390/j.issn.1672-1861.2017.02.030</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[14]腹部手術(shù)后咀嚼口香糖在促進(jìn)胃腸功能恢復(fù)過程中有明顯優(yōu)勢，可以減少第一次排氣時(shí)間及減少減少發(fā)生腸梗阻的風(fēng)險(xiǎn)、促進(jìn)腸鳴音的復(fù)原以及加快出院進(jìn)程ADDINEN.CITEADDINEN.CITE.DATA[15]等。此方法是一類容易、便利、廉價(jià)、安全的方法。術(shù)后咀嚼口香糖的益處已經(jīng)在多種類型的手術(shù)中得到證實(shí)，包括婦科腹部術(shù)后ADDINEN.CITE<EndNote><Cite><Author>劉佳佳</Author><Year>2019</Year><RecNum>45</RecNum><DisplayText><styleface="superscript">[16]</style></DisplayText><record><rec-number>45</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1732109852">45</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>劉佳佳</author></authors></contributors><auth-address>泗陽康達(dá)醫(yī)院婦產(chǎn)科;</auth-address><titles><title>咀嚼口香糖對(duì)改善婦科腹部手術(shù)后患者胃腸道功能恢復(fù)的影響</title><secondary-title>實(shí)用婦科內(nèi)分泌電子雜志</secondary-title></titles><periodical><full-title>實(shí)用婦科內(nèi)分泌電子雜志</full-title></periodical><pages>104+107</pages><volume>6</volume><number>21</number><keywords><keyword>婦科腹部手術(shù)</keyword><keyword>咀嚼口香糖</keyword><keyword>胃腸道功能</keyword></keywords><dates><year>2019</year></dates><isbn>2095-8803</isbn><call-num>11-9356/R</call-num><urls><related-urls><url>/doi/10.16484/ki.issn2095-8803.2019.21.077</url></related-urls></urls><electronic-resource-num>10.16484/ki.issn2095-8803.2019.21.077</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[16]腹腔鏡下膽囊切除術(shù)后ADDINEN.CITE<EndNote><Cite><Author>楊劍</Author><Year>2021</Year><RecNum>36</RecNum><DisplayText><styleface="superscript">[17]</style></DisplayText><record><rec-number>36</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1732109852">36</key></foreign-keys><ref-typename="Thesis">32</ref-type><contributors><authors><author>楊劍</author></authors><tertiary-authors><author>楊生虎,</author></tertiary-authors></contributors><titles><title>假飼對(duì)腹腔鏡下膽囊切除術(shù)術(shù)后胃腸功能恢復(fù)的影響</title></titles><keywords><keyword>假飼</keyword><keyword>腹腔鏡膽囊切除術(shù)</keyword><keyword>胃腸功能</keyword><keyword>日間手術(shù)</keyword><keyword>加速康復(fù)外科</keyword></keywords><dates><year>2021</year></dates><work-type>碩士</work-type><urls><related-urls><url>/doi/10.27740/ki.gqhdx.2021.000246</url></related-urls></urls><electronic-resource-num>10.27740/ki.gqhdx.2021.000246</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[17]及結(jié)直腸癌手術(shù)后ADDINEN.CITE<EndNote><Cite><Author>瞿晶晶</Author><Year>2023</Year><RecNum>27</RecNum><DisplayText><styleface="superscript">[18]</style></DisplayText><record><rec-number>27</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1732109852">27</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>瞿晶晶</author><author>陸信燕</author></authors></contributors><auth-address>南通瑞慈醫(yī)院,揚(yáng)州大學(xué)第四臨床醫(yī)學(xué)院;</auth-address><titles><title>階梯式量化活動(dòng)聯(lián)合假飼在老年結(jié)直腸癌手術(shù)后康復(fù)中的應(yīng)用——評(píng)《結(jié)直腸癌的治療與康復(fù)》</title><secondary-title>中國實(shí)驗(yàn)方劑學(xué)雜志</secondary-title></titles><periodical><full-title>中國實(shí)驗(yàn)方劑學(xué)雜志</full-title></periodical><pages>259</pages><volume>29</volume><number>17</number><dates><year>2023</year></dates><isbn>1005-9903</isbn><call-num>11-3495/R</call-num><urls><related-urls><url>/middle/abstract?v=At0rObma_qOLEulywNm4XeI9Wf8-igUe4tTXGu5VHSNRHuACRt_bBBZwFccWNFBVZYmfDW8gyhru63KNsMubnsDuakxC1Ncrv7mb8trmp4x6Dz8hxJ_5falin-ZWlTX0UssIckhdWUnX8hz4FVQPAY0AXkJVZ_tyHz15X3huqad5yM6NXycOwhFzScZrK-rWsWmnSPl_Cbo=&uniplatform=NZKPT&language=CHS&scence=null</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[18]等。咀嚼口香糖促進(jìn)胃腸功能恢復(fù)的作用機(jī)制在腹部術(shù)后病人的恢復(fù)時(shí)間通常是3-5天ADDINEN.CITE<EndNote><Cite><Author>Iskander</Author><Year>2024</Year><RecNum>26</RecNum><DisplayText><styleface="superscript">[19]</style></DisplayText><record><rec-number>26</rec-number><foreign-keys><keyapp="EN"db-id="rv0zerxvhtfwene2vxzvx0zfdxretftpzvf2"timestamp="1745422066">26</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>Iskander,O.</author></authors></contributors><auth-address>DepartmentofSurgery,FacultyofMedicine,JazanUniversity,SaudiArabia.</auth-address><titles><title>Anoutlineofthemanagementandpreventionofpostoperativeileus:Areview</title><secondary-title>Medicine(Baltimore)</secondary-title></titles><periodical><full-title>Medicine(Baltimore)</full-title></periodical><pages>e38177</pages><volume>103</volume><number>24</number><keywords><keyword>Humans</keyword><keyword>*PostoperativeComplications/prevention&control</keyword><keyword>*Ileus/prevention&control/etiology</keyword><keyword>RiskFactors</keyword><keyword>ChewingGum</keyword><keyword>Probiotics/therapeuticuse</keyword><keyword>EnhancedRecoveryAfterSurgery</keyword></keywords><dates><year>2024</year><pub-dates><date>Jun14</date></pub-dates></dates><isbn>0025-7974(Print) 0025-7974</isbn><accession-num>38875379</accession-num><urls></urls><custom1>Theauthorshavenofundingandconflictsofinteresttodisclose.</custom1><custom2>PMC11175850</custom2><electronic-resource-num>10.1097/md.0000000000038177</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[19]，如果胃腸功能紊亂的發(fā)生會(huì)使住院與傷口愈合的時(shí)間延長以及提高腹外疝的發(fā)生的潛在風(fēng)險(xiǎn)使患者經(jīng)濟(jì)壓力加重。雖然手術(shù)、炎癥與麻醉劑等多種的因素會(huì)促使胃腸功能障礙的發(fā)生。但是對(duì)其發(fā)病機(jī)制的了解仍然是有限的。咀嚼口香糖ADDINEN.CITE<EndNote><Cite><Author>楊劍</Author><Year>2020</Year><RecNum>37</RecNum><DisplayText><styleface="superscript">[20]</style></DisplayText><record><rec-number>37</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1732109852">37</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>楊劍</author><author>楊生虎</author><author>張成強(qiáng)</author><author>姜超</author></authors></contributors><auth-address>青海大學(xué)青海大學(xué)附屬醫(yī)院;</auth-address><titles><title>假飼對(duì)腹部術(shù)后腸梗阻治療效果的研究進(jìn)展</title><secondary-title>中西醫(yī)結(jié)合心血管病電子雜志</secondary-title></titles><periodical><full-title>中西醫(yī)結(jié)合心血管病電子雜志</full-title></periodical><pages>31-32</pages><volume>8</volume><number>31</number><keywords><keyword>假飼</keyword><keyword>術(shù)后腸梗阻</keyword><keyword>胃腸道功能恢復(fù)</keyword></keywords><dates><year>2020</year></dates><isbn>2095-6681</isbn><call-num>11-9336/R</call-num><urls><related-urls><url>/doi/10.16282/11-9336/r.2020.31.022</url></related-urls></urls><electronic-resource-num>10.16282/11-9336/r.2020.31.022</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[20]是一種“假喂養(yǎng)”或“假飼”行為。咀嚼口香糖可以模擬吃飯的過程，使活頭-迷走神經(jīng)受到刺激而發(fā)生反射然后促進(jìn)唾液分泌加快恢復(fù)胃腸道動(dòng)力。這種神經(jīng)反射不止可以激活消化系統(tǒng)的生理功能，還可以通過神經(jīng)信號(hào)的傳遞加速胃腸蠕動(dòng)的恢復(fù)。咀嚼口香糖ADDINEN.CITE<EndNote><Cite><Author>Firmanti</Author><Year>2020</Year><RecNum>154</RecNum><DisplayText><styleface="superscript">[21]</style></DisplayText><record><rec-number>154</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1742547576">154</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>TriaAnisaFirmanti</author><author>TintinSukartini</author><author>IlyaKrisnana</author></authors></contributors><auth-address>FacultyOfNursingUniversitasAirlangga</auth-address><titles><title>Areviewonreducingtheincidenceofpostoperativeileusbychewinggum,consumingcoffeeorwarmwaterpostabdominalsurgery</title><secondary-title>MEDISAINS</secondary-title></titles><periodical><full-title>MEDISAINS</full-title></periodical><pages>24-34</pages><volume>18</volume><number>1</number><dates><year>2020</year></dates><isbn>1693-7309</isbn><urls><related-urls><url>/kcms2/article/abstract?v=vSXt4VHTcs6B_QUFwMbeQQOVq8_pLfG9R_h2JB2XQFD_DP-LjSBAd_eHWs2X8fHsXqxbxmKW33OuCyh1N9UsIIF9Qn8QBRGXE6fmVwcSW6E48QuuxNDHfWK1JMMeeb0oCTrPaFRFd6bjH5MfJrACCwCUyoijfVV5Yi6-b2kxVVapKNExNFktLNBGPSykcgT_odUsJihsw8moc1bBZu4OSO3sP6aQdDeD&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[21]，還可以促進(jìn)多種胃腸激素的分泌，例如胃泌素、胰多肽和神經(jīng)降壓素等。這些激素的釋放有助于調(diào)節(jié)胃腸功能并且能減輕炎癥反應(yīng)。而且ADDINEN.CITE<EndNote><Cite><Author>林巧娜</Author><Year>2023</Year><RecNum>147</RecNum><DisplayText><styleface="superscript">[22]</style></DisplayText><record><rec-number>147</rec-number><foreign-keys><keyapp="EN"db-id="d00f5adxdew2sbe95whpsdsxwrp5daw2rfs2"timestamp="1741698284">147</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>林巧娜</author></authors></contributors><auth-address>福建醫(yī)科大學(xué)附屬第二醫(yī)院;</auth-address><titles><title>咀嚼口香糖聯(lián)合運(yùn)動(dòng)指導(dǎo)對(duì)結(jié)腸鏡受檢者腸道準(zhǔn)備質(zhì)量的影響</title><secondary-title>基層醫(yī)學(xué)論壇</secondary-title></titles><periodical><full-title>基層醫(yī)學(xué)論壇</full-title></periodical><pages>70-72</pages><volume>27</volume><number>27</number><keywords><keyword>咀嚼口香糖</keyword><keyword>運(yùn)動(dòng)指導(dǎo)</keyword><keyword>結(jié)腸鏡檢查</keyword><keyword>腸道準(zhǔn)備</keyword></keywords><dates><year>2023</year></dates><isbn>1672-1721</isbn><cal