In order to observe electrolyte changes before and after scheduled abdominal surgery and effect of prompt potassium supplement on the recovery of gastrointestinal function, electrolytes in 69 patients were tested before and after surgery, and the recovery of the gastrointestinal function was observed.The results showed that after surgery the levels of K＋, Na＋ and Cl＋ were decreased dramatically (Ｐ＜0.05) but still within the normal range, with no distinctive change in Ca２＋ and Mg２＋. No correlation between the amount of blood transfusion and potassium was detected. Prompt potassium supplement contributed to the quick recovery of gastrointestinal function.This suggests that with normal renal function, blood transfusion during the operation will not cause hyperkalemia, potassium supplement might begin on the first day when the patient begins to urinale.
Objective To investigate the relationship between the gastrointestinal function and ventilator-associated pneumonia (VAP) in critically ill patients who underwent invasive mechanical ventilation. Methods One-hundred and fifty-three cases of critically ill patients receiving mechanically ventilation were recruited in the study. After 5 days of ventilation, the gastrointestinal function score and the C-reactive protein (CRP) of each patient were recorded. The incidence of VAP was recorded during hospitalization. According to the incidence of VAP, all patients were divided intoaVAP group and a non-VAP group. The relationship between gastrointestinal function score and the incidence of VAP was analyzed. The relationship between CRP level and severity degree of VAP was also analyzed. Results VAP occurred in 42 cases with the incidence of 27.45%. The gastrointestinal function score (1.9±1.0 vs. 0.8±1.0, P < 0.05) and CRP level [(52.38±12.06) mg/L vs. (36.69±11.08)mg/L, P < 0.05] were both higher in the VAP group than those in the non-VAP group. At gastrointestinal function score of 0 - 3, the CRP levels were all higher in the VAP group than those in the non-VAP group (P < 0.05). The incidence of VAP was 8.33%, 23.68%, 45.45%, and 59.09% at gastrointestinal function score of 0, 1, 2 and 3, respectively, with significant differences between each other(P < 0.05). Conclusion For critically ill patients receiving invasive mechanical ventilation, the more severe the damage of gastrointestinal function is, the higher the incidence of VAP is, and the more serious the disease is.
ObjectiveTo investigate the role of somatostatin in gastrointestinal function after operation for treatment of abdominal injury patients. MethodsSixty patients with abdominal trauma were divided into somatostatin in treatment group (n=30) and the conventional treatment control group (n=30). The amount of gastrointestinal decompression drainage, bowel sounds recovery time, exhaust time, defecation time, and the levels of serum C reactive protein, TNF-α, IL-6, and IL-8 after operation in two groups were observed. ResultsSomatostatin treatment group recovery time of bowel sounds, exhaust time, and defecation time were earlier than the control group, hospitalization time shortened, and the amount of gastrointestinal decompression drainage reduced (P < 0.05), The levels of serum C reactive protein, TNF-α, IL-6 and IL-8 of somatostatin treatment group were lower than those in control group (P < 0.05), and the magnitude of decline above index in the somatostatin treatment group were greater than that in the control group (P < 0.05). ConclusionSomatostatin can promote the recovery of gastrointestinal function in patients after operation in abdominal injury.
ObjectiveTo investigate the influence of enteral nutrition (EN) and total parenteral nutrition (TPN) on liver, kidney and gastrointestinal function in patients after esophagectomy. MethodsA total of 124 patients with esophageal cancer who underwent esophagectomy in the Affiliated Hospital of Guangdong Medical College from January 2012 to August 2013 were enrolled in this study. There were 71 male and 53 female patients with their average age of 59.7 years (range 31 to 85 years). All the patients were randomly divided into an experimental group and a control group. Postoperatively, patients in the experimental group received EN via nasogastric/nasointestinal tube, and patients in the control group received TPN. Preoperatively, 1, 3 and 7 days postoperatively, plasma alanine transaminase (ALT), aspartate transaminase (AST), indirect bilirubin (I_BIL), direct bilirubin (DB), total bilirubin (TB), total protein (TP) and albumin (ALB) were examined to evaluate liver function, blood urea nitrogen (BUN) and serum creatinine (Scr) were examined to evaluate renal function. Postoperative time to first audible bowel sounds, time to first flatus, and time to first stool were examined to evaluate gastrointestinal function. ResultsThere was no statistical difference in ALT, AST, I_BIL, DB or TB preoperatively and on the 1st postoperative day between the 2 groups (P > 0.05), but these parameters of the experimental group were significantly lower than those of the control group on the 3rd and 7th postoperative day (P < 0.05). There was no statistical difference in TP or ALB between the 2 groups (P > 0.05). There was no statistical difference in BUN or Scr preoperatively, on the 1st or 3rd postoperative day between the 2 groups (P > 0.05). BUN (4.94±1.07 mmol/L vs. 6.67± 2.88 mmol/L, P < 0.05) and Scr (52.50±12.46 μmol/L vs. 68.23±7.61 μmol/L, P < 0.05) of the experimental group were significantly lower than those of the control group on the 7th postoperative day. Postoperative time to first audible bowel sounds (42.00±1.68 hours vs. 50.00±1.54 hours), time to first flatus (64.15±10.35 hours vs. 70.64±14.73 hours) and time to first stool (4.20±1.50 days vs. 5.20 ±1.40 days) of the experimental group were significantly shorter than those of the control group (P < 0.05). ConclusionPostoperative EN can promote the recovery of gastrointestinal function, and has less influence on liver and kidney function, which is beneficial to postoperative recovery and morbidity reduction after esophagectomy.
ObjectiveTo systematically review the effect and influence of gum chewing on the recovery of gastrointestinal function in gynecological patients after operation. MethodsEBSCO, MEDLINE, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials of gum chewing on gastrointestinal function recovery in patients after gynecological surgery from inception to September 30th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. RevMan 5.3 software was then used to perform the meta-analysis. ResultsA total of 9 studies were included, involving 962 patients. Meta-analysis results showed that the time of first flatus (MD=–8.34, 95%CI –10.72 to –5.95, P<0.000 01), the time of first defecation (MD=–14.97, 95%CI –29.28 to –0.66, P<0.04), and the recovery time of bowel sounds (MD=–5.83, 95%CI –10.15 to –1.51, P=0.008) of gum chewing group was significantly shorter than that of the control group, and the incidence of abdominal distension was decreased after gynecological surgery (RR=0.24, 95%CI 0.08 to 0.74, P=0.01). According to the results of subgroup analysis, the time of first flatus of the gum chewing group was significantly shorter than that of the control group in laparoscopy (MD=–5.43, 95%CI –7.12 to –3.73, P<0.000 01), laparotomy (MD=–10.46, 95%CI –13.56 to –7.97, P<0.000 01) and abdominal surgery (MD=–10.64, 95%CI –13.01 to –8.26, P<0.000 01); the first defecation time after laparotomy (MD=–29.18, 95%CI –46.03 to –12.33, P=0.000 7), and abdominal surgery (MD=–14.24, 95%CI –24.27 to –4.21, P=0.005) in chewing gum group was significantly shorter than that in the control group; however, there was no significant difference in the laparoscopy group (MD=–2.97, 95%CI –12.94 to 7.00, P=0.56). ConclusionsThe systematic review and meta-analysis shows that gum chewing after gynecological surgery can shorten the time of first flatus, first defecation, and first bowel movement, and reduce the incidence of abdominal distension. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.