The Application Of Gum Chewing With Early Semi-fluid Diet In The Recovery Of Gastrointestinal Function After Laparoscopic Cholecystectomy

Objective:To observe the effect and safety of Gum Chewingwith Early Semifluid Diet in the recovery of gastrointestinal function after laparoscopic gallbladder surgery,and to provide scientific guidance for promoting recovery of gastrointestinal function after laparoscopic cholecystectomy in patients with gallstones.Methods:From August 2015 to August 2016,patients with gallstones treated with laparoscopic cholecystectomy in Jintan District Hospital of Traditional Chinese Medicine,Changzhou,Jiangsu Province were enrolled.The subjects were divided into gum chewing group,semi-liquid,and liquid groups using a random number table.The patients in the gum chewing groupwere treated with gum chewing andearly semi-fluid diet.The patients in the semi-liquid group were treated with semi-fluiddiet alone,and the patients in the liquid group were given a gradual diet according to conventional methods.The recovery time of gastrointestinal function(resuming peristaltic sound,first anus exhaust time,first time of bowel movement time),gastrointestinal symptoms(nausea and bloating),MTL,GAS,Na~+,K~+,Cl~—,incidence of postoperative complications and degree of oral mucosal moisture in the three groups were analyzed.Results:Total of 108 patients were recruited in and 7 patients did not complete the ex periment.There were 101 patients completed the experiment,33 subjects in thegum chewing group,34 subjects in the semi-liquid group and 34 subjects in the liquid group.Th ere was nosignificant difference in demographic chracteristics,preoperative gastrointestinal symptoms(nausea and bloating),degree of oral mucosal moisture,MTL,GAS and Na~+,K~+,Cl~—(P>0.05).(2)The gastrointestinal function recovery timein gum chewing group were significantly short compared with that in the other two groups.In the gum chewing group,the resuming peristaltic sound recovery time(8.41+1.55 h)was significantly lower than that in the semi-fluid group(9.34+1.9 h)and the liquid group(10.21+1.84 h),and the first anus exhaust time(20.14+2.38h)in the gum chewing group was significantly lower than that of the semi-fluid group(24.79+2.05h)and the liquid group(26.52+2.45h),(P<0.05).(3)As to the laboratory indexes,MTL in the gum chewing group(260.61±30.5ng/l)was significantly higher than that in semi-liquid(206.06±38.45ng/l)and the liquid group(178.09±27.78ng/l),(P<0.05).GAS in the gum chewing group(62.27±16.42ug/l)was significantly higher than that in semi-liquid(53.65±17.85ug/l)and the liquid group(45.29±11.79ug/l),(P<0.05);There was no significant difference in Serum potassium,sodium,chlorineamong the three groups(P>0.05);(4)As to gastrointestinal symptoms,2 patients with II III nausea,2patients with II III abdominal distension in gum chewing group.7 patients with II III nausea,7 patients with II III abdominal distension in semi-liquid group.7 patients with II III nausea,8 patients with II III abdominal distension in liquid group.The incidence of gastrointestinal symptoms in gum chewing group was significantly lower than that in semi-liquid group or fluid group(P<0.05).(5)There was no significant difference in the incidence of complications amongthree groups(P>0.05).(6)Patients in the gum chewing group had significantly higher frequency(90.90%)of oral mucosal moisture than that in semi-liquid group or liquidgroup(64.70%and 55.88%,respectively;P<0.05).Conclusion:Gum chewing with early semi-fluid dietin patients undergoing laparoscopic cholecystectomycan safely and effectively promote the recovery of gastrointestinal function,reduce the incidence of nausea,abdominal distension,and improve serum MTL,GAS levels,degree of oral mucosal moisture,and no effect on Serum potassium,sodium,chlorine.