咀嚼口香糖对腹部手术后病人胃肠功能恢复的应用效果研究进展

目录1 前言 42 国内外研究现状 42.1 国外研究现状 42.2 国内研究现状 53 咀嚼口香糖促进胃肠功能恢复的作用机制 64 咀嚼口香糖促进胃肠功能恢复的临床应用效果 74.1 在结直肠手术中的应用 74.2 在腹腔镜胆囊切除术中的应用 74.3 在剖宫产手术中的应用 84.4 在其他腹部手术中的应用 85 讨论 96 结论 9中文摘要腹部手术后常因禁食禁水、麻醉等各方面原因导致患者术后胃肠功能障碍以及情绪的变化，会使患者推迟出院时间以及经济负荷加重。正因如此术后促进胃肠功能恢复就成为了腹部手术后的关键环节，对患者术后的康复速度多有影响。加速康复外科理念的提出是为了通过多种模式来促进病人在治疗期间生理与心理的康复。咀嚼口香糖作为一种只有咀嚼行为并没有经口进食的方式，使患者的发生反射而不造成其伤害，极大的帮助了患者腹部术后胃肠功能的更快康复，且没有副作用。从而使咀嚼口香糖作为一种简单、经济、安全的非药物干预措施，被广泛应用于腹部手术后促进胃肠功能的加速恢复的护理之中。它可以更快的减轻患者的经济压力、减轻患者的身体负担、使患者舒适度提升等。本文旨在描述咀嚼口香糖对腹部手术后病人胃肠功能恢复的生理机制及临床应用的效果，并对未来的临床研究提出建议及作出展望。关键词：腹部手术/咀嚼口香糖/假饲

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

咀嚼口香糖对腹部手术后病人胃肠功能恢复的应用效果研究进展前言腹部围手术期间，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>徐学军</author><author>李玲</author></authors></contributors><auth-address>浙江中医药大学护理学院;浙江省宁波市妇女儿童医院手术室;</auth-address><titles><title>宫颈癌3D腹腔镜手术患者手术室内采用针对性护理对预防应激反应寒战的价值</title><secondary-title>中国药物与临床</secondary-title></titles><periodical><full-title>中国药物与临床</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]患者常常因为手术产生的应激反应出现术后胃肠功能障碍，不仅影响患者的生理状态也对其心理产生消极的影响。在手术前常规的禁食禁水护理也会导致迷走神经的兴奋性降低以及手术产生的应激也可能提高交感神经的兴奋性导致术后疼痛加剧，甚至需要加用镇痛药物。这些原因都对患者的早期机体的康复没有帮助ADDINEN.CITE<EndNote><Cite><Author>陈慧颖</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>陈慧颖</author><author>孙颖</author><author>刘付懿斐</author></authors></contributors><auth-address>广州中医药大学;广州中医药大学深圳医院;</auth-address><titles><title>扶正通腑导滞法联合电针治疗腹腔镜术后胃肠功能紊乱疗效观察</title><secondary-title>现代中西医结合杂志</secondary-title></titles><periodical><full-title>现代中西医结合杂志</full-title></periodical><pages>59-62</pages><volume>29</volume><number>01</number><keywords><keyword>扶正通腑导滞法</keyword><keyword>电针阳明经穴</keyword><keyword>腹腔镜手术</keyword><keyword>胃肠功能</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]。咀嚼口香糖作为一种加速患者机体康复的方法，张哲等学者的分析可以看出ADDINEN.CITE<EndNote><Cite><Author>张哲</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>张哲</author><author>付雯</author><author>谢鑫</author><author>雷枭</author><author>陈艳</author><author>刘慧</author></authors></contributors><auth-address>川北医学院;川北医学院附属医院中医科;</auth-address><titles><title>咀嚼口香糖对剖宫产术后患者胃肠功能影响的Meta分析</title><secondary-title>海南医学</secondary-title></titles><periodical><full-title>海南医学</full-title></periodical><pages>930-936</pages><volume>31</volume><number>07</number><keywords><keyword>咀嚼口香糖</keyword><keyword>剖宫产术后</keyword><keyword>胃肠功能恢复</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]，咀嚼口香糖在促进腹部手术后胃肠功能恢复具有积极的影响。本综述旨在讨论咀嚼口香糖对腹部手术患者能否促进其胃肠功能早期恢复，总结出非药物干预措施的作用机制、临床应用以及局限性和未来的挑战。国内外研究现状国外研究现状加速康复外科理念（ERAS）是于20世纪90年代由丹麦Kehlet教授ADDINEN.CITE<EndNote><Cite><Author>中国加速康复外科专家组</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>中国加速康复外科专家组</author></authors></contributors><titles><title>中国加速康复外科围术期管理专家共识(2016版)</title><secondary-title>中华消化外科杂志</secondary-title></titles><periodical><full-title>中华消化外科杂志</full-title></periodical><pages>527-533</pages><volume>15</volume><number>06</number><keywords><keyword>外科疾病</keyword><keyword>加速康复外科</keyword><keyword>共识</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，通过ERAS协会不断改进与优化。是以多种学科、多种模式去减轻患者在身体机能恢复时期的应激反应。最终就是为了使患者安稳的度过治疗期并促进患者生理心理的康复。此理念在腹部手术中应用较为成功。术后胃肠功能障碍（postoperativegastrointestinaldysfunction,POGD）又称为术后胃肠功能紊乱，它是治疗期间的各种原因使得术后胃肠功能恢复延迟或停止的临床表现的总称。表现为手术后患者发生胃胀、恶心、排气时间延长等，甚至发生肠道梗阻。国外的研究数据ADDINEN.CITEADDINEN.CITE.DATA[5]可以看出，术前空腹时咀嚼口香糖可以缓解术前焦虑并提高患者术后的恢复质量，并且不会增加术后患者的误吸风险。ADDINEN.CITEADDINEN.CITE.DATA[6]据统计，在腹部手术后胃肠功能障碍的发生率高达48%，而通过咀嚼口香糖进行干预后这一比例可降至27%。结果表示，咀嚼口香糖作为一种“假饲”手段通过模拟进食的生理效应安全有效地促进胃肠功能的恢复。并且有研究表明ADDINEN.CITEADDINEN.CITE.DATA[7]咀嚼口香糖可以完全缓解术后恶心呕吐。在与传统的早期肠内营养相比，咀嚼口香糖具有操作简便、无创且成本低廉的优势被视为一种更安全、更易推广的术后康复干预措施。国内研究现状国内学者指出ADDINEN.CITE<EndNote><Cite><Author>付红萍</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>付红萍</author></authors></contributors><auth-address>江西省肿瘤医院综合科;</auth-address><titles><title>咀嚼口香糖对胃癌术后患者胃肠功能恢复的影响</title><secondary-title>护理实践与研究</secondary-title></titles><periodical><full-title>护理实践与研究</full-title></periodical><pages>88-89</pages><volume>14</volume><number>06</number><keywords><keyword>胃癌术后</keyword><keyword>口香糖</keyword><keyword>肛门排便排气时间</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]胃肠功能障碍发病原因多又复杂。其与腹部手术前长时间的禁食禁饮、术中使用麻醉、手术创伤以及术后活动减少、不能适应床上排便有极大的相关性。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]患者术后胃肠功能障碍的发生会影响患者生活质量以及使感染的风险增加。也有可能会引起焦虑、情绪暴躁等消极情绪ADDINEN.CITE<EndNote><Cite><Author>肖闪闪</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>肖闪闪</author><author>黄丽珊</author><author>王琳</author><author>许燕昕</author></authors></contributors><auth-address>广东省第二人民医院;广东药科大学护理学院;</auth-address><titles><title>腹部穴位按摩联合咀嚼口香糖在预防后路腰椎椎间融合术后患者便秘中的应用</title><secondary-title>齐鲁护理杂志</secondary-title></titles><periodical><full-title>齐鲁护理杂志</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>腰椎术后</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]。静脉补充液体、插鼻胃管、调节体内酸碱平衡、做好手术后床边护理、药物促进胃肠动力、早期下床活动等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]等传统的治疗干预手段缓解术后胃肠功能障碍效果不显著。使患者的生理恢复速度延缓并且对患者的心理状态造成消极影响，术后焦虑和抑郁的潜在发生性也极大提高。林渲果等学者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>辜晶荣</author><author>文红梅</author></authors></contributors><auth-address>广西壮族自治区南溪山医院胃肠外科;</auth-address><titles><title>咀嚼口香糖联合加速康复外科对胃癌患者术后肠功能恢复的影响</title><secondary-title>当代护士(中旬刊)</secondary-title></titles><periodical><full-title>当代护士(中旬刊)</full-title></periodical><pages>75-77</pages><volume>27</volume><number>06</number><keywords><keyword>胃癌术后</keyword><keyword>肠功能</keyword><keyword>咀嚼口香糖</keyword><keyword>加速康复外科</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让患者术后首次排气和排便时间平均缩短12.5小时。这种非药物治疗的干预可以促进胃肠功能的复原、使患者尽快出院并且可以减轻患者的经济负担和心理压力。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>王腾祺</author></authors></contributors><auth-address>内蒙古医科大学;巴彦淖尔市医院胃肠外科;</auth-address><titles><title>基于加速康复外科的非药物干预促进结直肠癌患者术后胃肠功能恢复的应用进展</title><secondary-title>内蒙古医学杂志</secondary-title></titles><periodical><full-title>内蒙古医学杂志</full-title></periodical><pages>1073-1076+1081</pages><volume>54</volume><number>09</number><keywords><keyword>结直肠肿瘤</keyword><keyword>肠</keyword><keyword>功能恢复</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]研究还能看出，咀嚼口香糖能有效减少术后恶心呕吐、胃潴留与肺部感染等并发症的发生，进一步提升患者的康复的质量。加快术后胃肠功能的恢复已经成为加速患者机体和心理康复的关键环节。也有研究表明ADDINEN.CITE<EndNote><Cite><Author>吴艳丽</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>吴艳丽</author><author>孔宪超</author></authors></contributors><auth-address>哈尔滨医科大学附属第二医院妇产科;</auth-address><titles><title>咀嚼口香糖对妇科腹腔镜术后胃肠功能恢复的影响</title><secondary-title>中国妇产科临床杂志</secondary-title></titles><periodical><full-title>中国妇产科临床杂志</full-title></periodical><pages>184-186</pages><volume>18</volume><number>02</number><keywords><keyword>妇科腹腔镜手术</keyword><keyword>咀嚼口香糖</keyword><keyword>胃肠功能恢复</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]腹部手术后咀嚼口香糖在促进胃肠功能恢复过程中有明显优势，可以减少第一次排气时间及减少减少发生肠梗阻的风险、促进肠鸣音的复原以及加快出院进程ADDINEN.CITEADDINEN.CITE.DATA[15]等。此方法是一类容易、便利、廉价、安全的方法。术后咀嚼口香糖的益处已经在多种类型的手术中得到证实，包括妇科腹部术后ADDINEN.CITE<EndNote><Cite><Author>刘佳佳</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>刘佳佳</author></authors></contributors><auth-address>泗阳康达医院妇产科;</auth-address><titles><title>咀嚼口香糖对改善妇科腹部手术后患者胃肠道功能恢复的影响</title><secondary-title>实用妇科内分泌电子杂志</secondary-title></titles><periodical><full-title>实用妇科内分泌电子杂志</full-title></periodical><pages>104+107</pages><volume>6</volume><number>21</number><keywords><keyword>妇科腹部手术</keyword><keyword>咀嚼口香糖</keyword><keyword>胃肠道功能</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]腹腔镜下胆囊切除术后ADDINEN.CITE<EndNote><Cite><Author>杨剑</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>杨剑</author></authors><tertiary-authors><author>杨生虎,</author></tertiary-authors></contributors><titles><title>假饲对腹腔镜下胆囊切除术术后胃肠功能恢复的影响</title></titles><keywords><keyword>假饲</keyword><keyword>腹腔镜胆囊切除术</keyword><keyword>胃肠功能</keyword><keyword>日间手术</keyword><keyword>加速康复外科</keyword></keywords><dates><year>2021</year></dates><work-type>硕士</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]及结直肠癌手术后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>陆信燕</author></authors></contributors><auth-address>南通瑞慈医院,扬州大学第四临床医学院;</auth-address><titles><title>阶梯式量化活动联合假饲在老年结直肠癌手术后康复中的应用——评《结直肠癌的治疗与康复》</title><secondary-title>中国实验方剂学杂志</secondary-title></titles><periodical><full-title>中国实验方剂学杂志</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。咀嚼口香糖促进胃肠功能恢复的作用机制在腹部术后病人的恢复时间通常是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]，如果胃肠功能紊乱的发生会使住院与伤口愈合的时间延长以及提高腹外疝的发生的潜在风险使患者经济压力加重。虽然手术、炎症与麻醉剂等多种的因素会促使胃肠功能障碍的发生。但是对其发病机制的了解仍然是有限的。咀嚼口香糖ADDINEN.CITE<EndNote><Cite><Author>杨剑</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>杨剑</author><author>杨生虎</author><author>张成强</author><author>姜超</author></authors></contributors><auth-address>青海大学青海大学附属医院;</auth-address><titles><title>假饲对腹部术后肠梗阻治疗效果的研究进展</title><secondary-title>中西医结合心血管病电子杂志</secondary-title></titles><periodical><full-title>中西医结合心血管病电子杂志</full-title></periodical><pages>31-32</pages><volume>8</volume><number>31</number><keywords><keyword>假饲</keyword><keyword>术后肠梗阻</keyword><keyword>胃肠道功能恢复</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]是一种“假喂养”或“假饲”行为。咀嚼口香糖可以模拟吃饭的过程，使活头-迷走神经受到刺激而发生反射然后促进唾液分泌加快恢复胃肠道动力。这种神经反射不止可以激活消化系统的生理功能，还可以通过神经信号的传递加速胃肠蠕动的恢复。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]，还可以促进多种胃肠激素的分泌，例如胃泌素、胰多肽和神经降压素等。这些激素的释放有助于调节胃肠功能并且能减轻炎症反应。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>福建医科大学附属第二医院;</auth-address><titles><title>咀嚼口香糖联合运动指导对结肠镜受检者肠道准备质量的影响</title><secondary-title>基层医学论坛</secondary-title></titles><periodical><full-title>基层医学论坛</full-title></periodical><pages>70-72</pages><volume>27</volume><number>27</number><keywords><keyword>咀嚼口香糖</keyword><keyword>运动指导</keyword><keyword>结肠镜检查</keyword><keyword>肠道准备</keyword></keywords><dates><year>2023</year></dates><isbn>1672-1721</isbn><cal