| Objective: To explore and analyze the effectiveness and safety of sham feeding for the recovery of gastrointestinal function after laparoscopic cholecystectomy(LC),providing a new reference method for rapid postoperative recovery of abdominal surgery patients,Providing an idea for the development and promotion of ambulatory laparoscopic cholecystectomy(ALC).Methods : In this study,200 patients with gallbladder stones who underwent LC who were admitted to the Department of Abdominal Laparoscopic Surgery of Qinghai University Affiliated Hospital from December 2019 to November 2020 were selected according to the inclusion and exclusion criteria.They were divided into a sham feeding group and a control group by a random number table.The sham feeding group: routine care after the Department of Abdominal Laparoscopic Surgery + 2 hours after the operation,the patients started to chew xylitol sugar-free gum for 30 minutes each time.Two gums at a time,the next chewing gum was performed at an interval of 2 hours,a total of 3 chewings,no chewing at night;control group: routine care after the Department of Abdominal Laparoscopic Surgery.The data of the two groups were compared in terms of postoperative bowel sound recovery time,first postoperative anal exhaust time,postoperative creactive protein level,postoperative neutrophil to lymphocyte count ratio(NLR),surgery Post-gastrin levels,postoperative nausea and vomiting,abdominal distension,dry mouth,bad breath and other complications,as well as differences in the patient’s hospital stay,hospital costs,and hospital satisfaction scores.The results are obtained through corresponding statistical analysis.Results : In this trial,200 patients who met the criteria were included,11 cases were dropped,and a total of 189 patients completed the trial.Among them,3 patients in the sham feeding group were over 2 hours postoperatively,1 was unconscious at 2hours postoperatively,and 2 patients had nausea,vomiting and chewing intolerance after surgery.A total of 94 patients completed the test;4 patients in the control group had surgery over 2 hours.One case was converted to laparotomy,and a total of 95 patients completed the trial.There was no statistical difference between the two groups of patients in terms of gender,age,family,operation time,postoperative c-reactive protein level,postoperative neutrophil count to lymphocyte count ratio,patient hospitalization time,and hospitalization expenses(p> 0.05).The postoperative bowel sound recovery time in the sham feeding group was 8.36±0.77 h,and the postoperative bowel sound recovery time in the control group was 8.62±0.91 h.The difference between the two groups was statistically significant(t=2.139,p=0.034);sham feeding The time of the first postoperative anus in the group was 20.16±1.80 h,and the time of the first postoperative anus in the control group was 20.74±1.84 h.The difference between the two groups was statistically significant(t=2.179,p=0.031);The gastrin level on the first postoperative day was 68.99±14.22ng/L,and the gastrin level in the control group was 64.18±14.64ng/L on the first postoperative day.The difference between the two groups was statistically significant(t=2.276,p=0.024)The incidence of postoperative nausea and vomiting in the sham feeding group was 10.64%,and the incidence of postoperative nausea and vomiting in the control group was 24.21%.The difference between the two groups was statistically significant(χ~2=6.039,p=0.014);postoperative abdominal distension occurred in the sham feeding group The rate of postoperative abdominal distension was 6.38%.The incidence of postoperative abdominal distension in the control group was 15.79%.The difference between the two groups was statistically significant(χ~2=4.233,p=0.040);the incidence of postoperative dry mouth and bad breath in the sham feeding group was 29.79%.The incidence of dry mouth and bad breath was 69.47%,and the difference between the two groups was statistically significant(χ~2=29.768,p<0.001);the satisfaction score of the sham feeding group was 96.80±1.99 points,and the satisfaction score of the control group was 96.08±2.00 points.The difference between the two groups was statistically significant(t=2.455,p=0.015).Conclusion : Sham feeding can speed up the recovery of gastrointestinal function in patients with LC,speed up the recovery of patients after surgery,and improve the comfort of patients in hospital;sham feeding is a safe,simple,economical,and widely accepted measure without obvious disadvantages.Reactions and side effects are worthy of clinical promotion. |
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