| Objective:To investigate the effects of drinking 10%glucose solution 2 hours before laparoscopic hysterectomy and chewing gum 2 hours after waking up after laparoscopic hysterectomy on gastrointestinal function in patients with laparoscopic hysterectomy,and further explore its effects on the whole perioperative period.120 patients who planned to perform laparoscopic total hysterectomy with or without double adnexectomy in our hospital from March 2021 to December 2021 were randomly divided into 4 groups:A-D（n=30）.Group A was forbidden to eat at 22:00 the day before operation;Group B was forbidden to eat and drink at 22:00 the day before the surgery,and the sufferers were instructed to drink 10%glucose solution prepared by doctor a in advance 2 hours before entering the operating room（the drinking amount was calculated as the actual weight of the patients before operation（kg）×4ml）,the anesthesia induction in our hospital is generally after 8:30,so the patient is advised to finish drinking before 6:30[1];Group C was forbidden to eat and drink at 22:00 the day before operation.The patient began to chew chewing gum for 10 minutes after extubation and waking up for 2 hours after operation,chewed 2 tablets every 4 hours[2],and did not chew at night until the day of exhaust;Group D was forbidden to eat and drink sugar water at 20:00 the day before the surgery,the patients in group B began to chew gum for 10 minutes after extubation for 2 hours,and chew 2 tablets every 4 hours.Suppose group B eats sugary drinks and group D is less than 2H away from anesthesia induction,the anesthesia and operation time shall be postponed in time.Patients classified as within groups C and D could not be conducted chew gum if they are not fully awake 2h after operation.Relatives need to be watched after when they eat chewing gum,so as to prevent the patients from swallowing or suffocating during chewing gum and ensure the safety of patients after operation.Anesthesiologists use the same anesthesia technology to provide general anesthesia for all patients.All the steps should be a team.All patients underwent laparoscopic total hysterectomy with or without salpingo and oophorectomy.The postoperative patients returned to the ward safely,and all patients received the same postoperative care.In order to check the bowel sound,two members of the research team used the stethoscope every 2 hours from the second hour after operation until they noticed the first bowel sound and recorded the time.They asked the patients and their families to observe the first exhaust time and told the postoperative follow-up personnel[3].The visual analogue scale（VAS）of thirst and hunger was recorded 2H and 30min before operation.Score the patient in the range of zero to three points.The score of thirst is as follows:0-the patient has no thirst;1 point-the patient feels slightly dry mouth but has no need for drinking water;2 points-the patient feels moderately dry mouth,but can continue to endure;3-the patient is extremely thirsty,in urgent need of drinking water,and has symptoms of lack of water and peeling on the lips.According to the hunger score,0-the patient has no hunger;1 point-the patient feels slightly hungry but has no food requirements;2-the patient feels more hungry than before,but can continue to endure;3-the patient has a strong sense of hunger,weakness,sweating and other weak symptoms,and it is difficult to continue to wait[4].Record the patient’s postoperative complications,including intestinal paralysis,nausea,vomiting,abdominal distension,and dry mouth and bad breath（patients were visited after the operation,and the patients reported thirst,dry throat,urges to drink water,or the patient’s lips were chapped and peeling）.That is regarded as having dry mouth complications;patients with bad breath after operation are regarded as having bad breath complications).The patients were asked and recorded their satisfaction with the hospitalization before discharge.Results:1.There is no particularly obvious distinction and differences in personal information（age,BMI,etc.）and intraoperative conditions（bleeding volume,infusion volume,urine volume and operation duration）among the four groups（P>0.05）.2.Using the VAS scoring method for patients,the results showed a clear difference of thirst and hunger among the four groups（P<0.05）;There are clear differences in the VAS scores measured in thirsty cognition and hunger between BD group and group A（P<0.05）;There are clear differences in the VAS scores measured in thirsty cognition and hunger between group C and group B（P<0.05）;The VAS scores of thirst and hunger in group D were clear differences between group A and C（P<0.05）.Both groups B and D took 10%glucose solution orally before operation.Oral sugar water 2 hours before operation can alleviate the preoperative thirst and hunger of patients to a certain extent.3.Groups B and A show the obvious differences in the time of the first exhaust group,the first bowel sound recovery time and the first feeding time（P<0.05）,but there was no significant difference in the length of hospital stay between group B and A（P>0.05）;There were significant differences in the recovery time of the first bowel sound,exhaust and feeding time between group C and group A（P<0.05）,only in the recovery time of the first bowel sound between group C and B（P<0.05）,and there was no significant difference in the length of hospital stay between group A and group B（P>0.05）;There were significant differences in the recovery time of the First bowel sounds,exhaust,eating and time to enter the hospital between group A or group C and group B（P<0.05）.The first exhaust time of group A and group BCD was earlier than that of group A.4.There was no significant difference in intestinal paralysis,these groups of patients have wanted vomiting,nausea and stomach distension（P>0.05）;There were significant differences in dry mouth and bad breath between group CD and AB respectively（P<0.05）.The incidence of dry mouth and halitosis in CD group was lower than that in AB group.5.There was no significant difference in satisfaction between group C and A（P>0.05）.There was significant difference in satisfaction between group B and group D and A（P<0.05）.Patients in group B and D were both significantly more satisfied than in group A.Conclusion:1.Oral administration of 10%glucose solution at the dose of 4ml/kg two hours before laparoscopic total hysterectomy can alleviate the preoperative thirst and hunger of patients,shorten the recovery time of gastrointestinal function and improve the satisfaction of patients in hospital,but its high probability does not prevent the possibility of other symptoms after the surgery.2.Chewing gum 2 hours after laparoscopic hysterectomy can speed up the recovery time of gastrointestinal function and reduce the incidence of dry mouth and halitosis.3.Oral sugar water before laparoscopic hysterectomy with or without double appendectomy combined with chewing gum 2 hours after waking up after operation can alleviate the preoperative thirst and hunger of patients,shorten the first exhaust time after operation,promote the early peristalsis of gastrointestinal tract,reduce the incidence of postoperative dry mouth and halitosis,and the satisfaction level of all the patients entering the hospital will be improved,and the rehabilitation training process needed after the operation will be accelerated. |
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