Restoration Of Gastrointestinal Function After Gynecological Operation Factors Influencing Clinical Study

Objectives:The study using the clinical epidemiological research method, doing the prospective survey and research about these cases which are gynecologic abdominal operation, in order to exploring the restoration of gastrointestinal function influence factors during gynecological operation period, which will be provide basis clinical intervention for integrated traditional Chinese medicine and Western medicine, promoting the recovery of gastrointestinal function after gynecological operationMethods:According to the criteria and exclusion criteria, The patients after gynecologic abdominal surgery were collected from March,2011to November,2011in gynecology department of Guangdong Province Chinese medicine hospitial. filled in the CRF table, for these collection operation case, analyed the factors which affecting the recovery of gastrointestinal function. Processing the data using SPSS17.0software package, statistical methods using chi-square test, t test, Kaplan-Meier Cox proportional hazard model.Result:1.For these patients less than40years, preoperative TCM empirical syndrom, the first exhaust, defecation time shorter than these patients whese age over40years of age, postoperative TCM deficiency syndrome, the difference was statistically significant (P＜0.05), This result indicate that age and preoperative TCM syndrome are influenting factors of gastrointestinal function after gynecological operation.the patients whese Bowe habit are once a days the first exhaust time is shorter than these patients whese bowel habit are more than once a days, the difference was statistically significant (P＜ 0.05), This result indicate that patients bowel habit is the influenting factors of gastrointestinal function after gynecological operation.2. These patients first exhaust and defecate time is shorter whose preoperative without clean irrigation and full flow diet, preoperative ban fast and drink less than10hours than whose clean enema, preoperative24hours full flow and ban drink more than10hour, the difference was statistically significant(P＜0.05), This result indicate that the preoperative clean enema, the time of preoperative full flow diet and ban drink is the influenting factors of gastrointestinal function after gynecological operation.3. These patients first exhaust and defecate time is longer whose anesthesia are combined spinal-epidural anesthesia, long anesthesia time, operation mode are open, long operation time, many bleeding intraoperative than these patients with general anesthesia, short anesthesia time, operation mode ere endoscopic, short operation time, less bleeding in patients, the difference was statistically significant(P＜0.05), This result indicate that anesthesia, anesthesia time, operation mode, operation time, intraoperative bleeding are the influenting factors of gastrointestinal function after gynecological operation.4. These patients first exhaust and defecate time is longer whose postoperative semiliquid diet time later, with peritoneal cavity drainage tube and catheter placed longer time, postoperative use of PCEA, three days after postoperative fever than these patients postoperative semiliquid diet time earlier, with peritoneal cavity drainage tube and catheter placed shorter time, postoperative use of PCSA), three days after postoperative without fever, the difference was statistically significant(P＜0.05), This result indicate that postoperative semiliquid diet time, peritoneal cavity drainage tube and catheter placed time, postoperative analgesia pump type, postoperative fever are the influenting factors of gastrointestinal function after gynecological operation.5. The patients with hypokalemia, red blood cell count, hemoglobin level was decreased after operation, leukocyte levels were elevated, the difference was statistically significant (P＜0.05). These patients first exhaust and defecate time is longer whose postoperative serum potassium, hemoglobin, white blood cell levels are normal than these whose postoperative serum potassium, hemoglobin, white blood cell levels are abnormal, the difference was statistically significant (P＜.05). This result indicate that serum potassium, hemoglobin, white blood cell levels are the influenting factors of gastrointestinal function after gynecological operation.6. The age of the patients and postoperative started a half time and postoperative cumulative exhaust rate related (P<0.05), were independent factors influencing, elected to the model, the model was statistically significant (P＜0.05). At the age of invariable situation, postoperative24-47h, greater than or equal to48h semiliquid diet than postoperative less than24h semiliquid diet on postoperative exhaust effects, respectively isO.04times and0.01times. In the postoperative initiation of semiliquid diet time invariable situation, age greater than40years for postoperative exhaust effect is less than40yearsl.65times, older age, postoperative initiation of semiliquid diet of the late time, postoperative exhaust time.Mode of operation, postoperative hospitalization beginning half flow time and postoperative cumulative defecation rate related (P＜0.05), were independent factors influencing, elected to the model, the model was statistically significant (P＜0.05). In hospital operation mode under the condition of unchanged, postoperative24-47h, greater than or equal to48h semiliquid diet than postoperative less than24h semiliquid diet on postoperative defecation effect, respectively isO.48times and0.06times. In the postoperative initiation of semiliquid diet time invariable situation, open operation on postoperative defecation is the effect of endoscopic operationl.64times, operation mode for open, postoperative initiation of semiliquid diet of the late time, postoperative defecation time.Conclution1. the recovery of gastrointestinal function after abdominal surgery is the key link of rapid recovery, postoperative recovery of gastrointestinal function in postoperative patients with slow effect of comprehensive rehabilitation. Patient age, preoperative disease type, previous bowel habit, way of operation, preoperative full flow and fasting, abstinence time, preoperative cleansing enema before operation, syndrome of traditional Chinese medicine, anesthesia, anesthesia time, operation time, intraoperative bleeding, abdominal cavity drainage tube and catheter placed time, postoperative use of analgesia pump type, postoperative initiation of semiliquid diet time, postoperative blood potassium levels, postoperative hemoglobin levels, postoperative white blood cell level, postoperative fever can affect the restoration of gastrointestinal function after gynecological operation.2. In patients age, hospital operation, postoperative started a half time is the restoration of gastrointestinal function after gynecological operation independent factors. Operation mode for open operation, the older, catheter placed for longer periods of time, postoperative half flow of the late time, less favorable postoperative gastrointestinal recovery condition allows, in case of possible choice of laparoscopic operation, postoperative early removal of urinary catheter, early postoperative give semifluid food for gynecologic abdominal postoperative gastrointestinal function of the rapid rehabilitation has important clinical significance. The research for the restoration of gastrointestinal function after gynecological operation active intervention to provide a clinical reference.