| Objective:Postoperative xerostomia and gastrointestinal dysfunction are the common postoperative complicat ions in the patients after lumbar spine surgery under general anesthesia. Effective prevention and therapy to these two complications are scarce. This study aimed to apply a new intervention—dark plum spray to the postoperative patients with selective lumbar spine surgery under general anesthesia, to access and analysis the patients’subjective and objective indicators of saliva secretion function of and related parameters of gastrointestinal function to determine the effectiveness of dark plum spray to postoperative xerostomia and gastrointestinal dysfunction. The study ought to provide evidences to the application of dark plum spray in the postoperative care.Methods:This study enrolled 64 patients undergoing elective lumbar spine surgery under general anesthesia in accordance with the inclusion criteria from the department of spinal orthopaedics between July 2014 and March 2015. The 64 cases were randomly allocated into the experimental group (EG) and the control group(CG) with 32 cases in each group. The demographic information and the basic saliva secretion index were collected and accessed in both groups. The dark plum spray were used to moist mouths in the EG patients and the pure water spray were used to moist mouths in the CG patients after surgery. The whole study intervention lasted for 3 days. In the first-day intervention, the spray solution were applied every 15 minutes for 6 hours after surgery in each group, the saliva flow rate(SFR) and the oral mucosa moist degree (OMMD) were accessed every hour during the 6-hour intervention in first day. In the second and third day intervention, the spray solution were applied in each group every hour in the daytime, and the SFR and OMMG were accessed before interventions in the morning and after intervention in the evening. The exhaust time(ET), defecating time(DT), abdominal distension(AD) and glycerine enema usage(GEU) were recorded for each patient after surgery. At the end of the course, a comparison and evaluation was made to determine the clinical effect to postoperative Xerostomia and gastrointestinal dysfunction between the two groups.Results:In the study, the final valid samples were 60 cases,30 cases in EG and 30 cases in CG. The 4 abscission cases had no significant statistic differences in demographic indicators and the basic saliva secretion index compared to the 60 valid cases (P>0.05). There were also no significant statistic differences in the baseline data between EG and CG(P>0.05). The postoperative basic SFR and OMMG decreased significantly compared to the preoperative basic SFR and OMMG in both groups(P<0.05).In the longitudinal comparison of salivary function of the first day intervention in both groups, the SFR of EG increased significantly in all 6 hours compared to the postoperative basic SFR (P<0.05). In the first 4 hours, the SFR of EG was similar to the preoperative basic SFR, there were no significant statistic differences (P>0.05). In the last 2 hours, the SFR of EG were higher than the preoperative basic SFR, there were signif icant stat ist ic differences (P<0.05)。The SRG of CG in the first hour was similar to the postoperative basic SFR(P>0.05). In the second to sixth hour, the SFR of CG increased significantly in all 5 hours compared to the postoperative basic SFR (P<0.05). However, the SFR of CG was lower than the preoperative basic SFR in all 6 hours, there were significant statistic differences (P<0.05).During the 6-hour intervention in the first day,the OMMD of EG was significantly higher than the postoperative basic OMMD (P<0.05). In he first 5 hours, the OMMD of EG was significantly lower than the preoperative basic OMMD (P<0.05). In the sixth hour, the the OMMD of EG was similar to the preoperative basic OMMD(,there were no significant statistic differences (P>0.05). In the first hours, the OMMD of CG was similar to the postoperative basic OMMD, there were no significant statistc differences (P>0.05). In the second to sixth hours, the OMMD of CG increased significantly compared to the postoperative basic 0MMD(P< 0.05). However, in the whole 6 hours, the OMMD of CG was significantly lower than the preoperative basic OMMD(P<0.05).The SFR before intervention of EG in the second and third day was similar to the preoperative basic SFR, there were no significant stat i st ic differences (P>0.05). The SFR after intervention of EG in the second and third day increased significantly compared to the preoperative basic SFR (P<0.05), The SFR before intervention of CG in the second day was significantly lower than the preoperative basic SFR (P<0.05). The SFR before intervention in the third day and the SFR after intervention in the second and thi rd day of CG were simi lar to preoperative basic SFR, there were no significant statistic differences (P>0.05). The SFR of EG increased significantly after intervention in both the second and third day (P<0.05). The SRF of CG increased significantly after intervention in both the second and third day(P<0.05). The growth of SFR in the EG was significantly higher than the growth of SFR in the CG in both the second and third day(P<0.05). The OMMD before and after intervention of the EG and CG in the second and third day was similar to each other, there were no significant statistic differences (P>0.05).The average ET of EG was 12.67+7.89 h, and the average ET of CG was 16.13+3.98 h, there were significant stat istic differences (P<0.05). The average DT of EG was 62.72+16.59 h and he average DT of EG was 88.47 ±23.76 h, there were significant statistic differences (P<0.05). The incidence rate of AD in EG was 10% and the incidence rate of AD in EG was 47%, there were significant statistic differences (P<0.05). The rate of GEU of EG was 7% and the rate of GEU of EG was 43%, there were significant statistic differences (P<0.05).Conclusions:1.The dark plum spray can significantly increase the salivary secre tion and oral mucosa moist degree in the patients after general anes thesia lumbar spine surgery, accelerate the recovery process of suppre ssed salivary gland,shorten the duration of postoperative xerostomia, increase the comfort of postoperative patients and provide valid evid ence to treat the postoperative xerostomia.2. The dark plum spray can stimulate the nerve by fake feeding, to in crease gastrointestinal motility, increase the digestive enzyme secret ion, shorten the postoperative exhaust time and defecating time.decrea se the incidence rate of abdominal distension, alleviate the symptoms of inappetence and astriction.3. This study verifies the effectiveness of the dark plum spray to p ostoperative xerostomia and gastrointestinal dysfunction, and verify t he relation between the postoperative xerostomia and the postoperativ e gastrointestinal dysfunction. The dark plum spray is safe and effect ive, easy to use, It can apply to intervene early after surgery and can be widely use in the clinical setting. |
PDF Full Text Request