Clinical study on the effect of prebiotics on gastrointestinal recovery after laparoscopic exploration for benign gynecological diseases
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摘要:
目的 评估益生元在妇科良性疾病腹腔镜探查术后胃肠道功能恢复中的效果，为优化术后康复策略提供依据。 方法 选择2022年9月—2023年9月于杭州市第一人民医院妇科就诊的140例腹腔镜探查术患者，按照纳入、排除标准，使用随机数字表法将患者分为干预组(益生元治疗)和对照组(安慰剂治疗)，每组70例。比较2组患者术后首次排气和排便时间、胃肠道生活质量指数(GIQLI)及术后不良反应的发生率。 结果 干预组患者首次排气时间[(1.50±0.45)h vs.(2.75±1.20)h]和首次排便时间[(2.43±0.52)h vs.(3.58±0.61)h]均短于对照组(P＜0.05)；干预组患者出院后1周生活质量指数中躯体维度评分高于对照组(77.87±9.19 vs. 68.10±9.67，P＜0.05)；干预组患者出院时(55.94±15.34 vs. 63.50±18.27)和出院后1周(50.84±11.67 vs. 55.24±11.24)GIQLI评分均低于对照组(P＜0.05)；对照组出院时不良反应总发生率(包括腹胀、腹痛、呕吐、肠梗阻等)高于干预组[15.71%(11/70) vs. 2.86%(2/70)，P＜0.05]。 结论 益生元干预可显著缩短妇科良性疾病患者腹腔镜术后首次排气和排便时间，降低术后腹胀、腹痛等胃肠道不良反应发生率，并改善患者术后早期生活质量。 Abstract:Objective To assess the effect of prebiotics on gastrointestinal function recovery following laparoscopic exploration for benign gynecological diseases, and to provide evidence for optimizing postoperative rehabilitation strategies. Methods According to the inclusion and exclusion criteria, 140 patients with laparoscopic exploration at the Department of Gynecology of Hangzhou First People ' s Hospital from September 2022 to September 2023, were randomly divided into an intervention group (prebiotic treatment) and a control group (placebo), with 70 cases in each group. Time to first postoperative flatus and defecation, gastrointestinal quality of life index (GIQLI), and the incidence of postoperative adverse reactions were compared between the two groups. Results The time to first flatus [(1.50±0.45) h vs. (2.75±1.20) h] and the first defecation time [(2.43±0.52) h vs. (3.58±0.61) h] in the intervention group were shorter than those in the control group (P < 0.05), respectively. One week after discharge, the score of physical dimension in the intervention group was higher than that in the control (77.87±9.19 vs. 68.10±9.67, P < 0.05). The GIQLI scores of the intervention group at discharge (55.94±15.34 vs. 63.50±18.27) and one week after discharge (50.84±11.67 vs. 55.24±11.24) were lower than those of the control group (P < 0.05). The overall incidence of adverse reactions (abdominal distension, abdominal pain, vomiting, intestinal obstruction, etc.) in the control group was significantly higher than those in the intervention group [15.71% (11/70) vs. 2.86% (2/70), P < 0.05]. Conclusion Prebiotic intervention can significantly shorten the first exhaust and defecation time of patients with gynecological benign diseases after laparoscopic surgery, reduce the incidence of gastrointestinal adverse reactions such as postoperative abdominal distension and abdominal pain, and improve the early postoperative quality of life of patients. -
Key words:
- Probiotics /
- Gynecology /
- After laparoscopic exploration surgery
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表 1 2组妇科良性疾病患者一般资料比较
Table 1. Comparison of baseline characteristics between the two groups of patients with benign gynecological diseases
组别 例数 年龄(x±s，岁) 所患疾病[例(%)] 子宫肌瘤 卵巢囊肿 子宫内膜异位症 盆腔粘连 子宫腺肌症 其他 干预组 70 44.57±6.48 28(40.00) 16(22.86) 6(8.57) 8(11.43) 4(5.71) 8(11.43) 对照组 70 44.35±6.52 30(42.86) 15(21.43) 7(10.00) 8(11.43) 5(7.14) 5(7.14) 统计量 0.200a 0.982b P值 0.842 0.964 注：a为t值，b为χ2值。 
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表 2 2组妇科良性疾病患者胃肠道恢复情况比较(x±s, d)
Table 2. Comparison of gastrointestinal recovery in two groups of patients with benign gynecological diseases(x±s, d)
组别 例数 首次排气时间 首次排便时间 出院时间 干预组 70 1.50±0.45 2.43±0.52 7.20±2.64 对照组 70 2.75±1.20 3.58±0.61 7.58±2.58 t值 8.160 12.004 0.861 P值 ＜0.001 ＜0.001 0.391
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表 3 2组妇科良性疾病患者出院后1周生活质量比较(x±s)
Table 3. Comparison of quality of life between the two groups of patients with benign gynecological diseases at one week post-discharge(x±s)
组别 例数 心理 环境 躯体 社会 综合 干预组 70 81.89±8.78 75.13±8.98 77.87±9.19 79.81±8.12 80.56±7.45 对照组 70 81.45±8.90 74.90±9.46 68.10±9.67 79.60±7.93 78.77±9.26 t值 0.294 0.148 6.127 0.155 1.260 P值 0.769 0.883 ＜0.001 0.877 0.210
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表 4 2组妇科良性疾病患者术前、出院时和出院后GIQLI评分比较(x±s)
Table 4. Comparison of GIQLI scores before surgery, at discharge, and after discharge in two groups of patients with benign gynecological diseases(x±s)
组别 例数 术前 出院时 出院后1周 F值 P值 干预组 70 48.17±10.67 55.94±15.34 50.84±11.67 6.743 ＜0.001 对照组 70 47.86±12.34 63.50±18.27 55.24±11.24 20.992 ＜0.001 F值 0.928 -2.651 -2.272 P值 0.874 0.009 0.025 注：F时间=25.563，P时间＜0.001；F组间=7 096.043，P组间＜0.001；F时间*组间=2.907，P时间*组间=0.056。
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