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缓泻剂在快速通道全子宫切除术后胃肠功能恢复中的作用：一项双盲、安慰剂对照的随机化研究
Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study
Hansen CT, Sørensen M, Møller C  2009/5/27 10:50:39 
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Am J Obstet Gynecol, 2007,
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Abstract

Objective:

The purpose of this study was to determine the effect of early oral bowel stimulation with osmotic laxatives on gastrointestinal function, postoperative nausea and vomiting (PONV) and pain in patients who undergo fast-track abdominal hysterectomy.

Study Design:

This was a double-blind, placebo-controlled study of 53 women who were assigned randomly to either laxative (magnesium oxide+disodium phosphate) or placebo that was initiated 6 hours after the operation. Primary outcome was time to first defecation; the number of vomiting episodes; nausea and pain score were assessed on a visual analogue scale.

Results:

Time to first postoperative defecation was a median of 45 hours in the laxative group and a median of 69 hours in the placebo group (P<.0001). There were no significant differences between groups in pain scores, PONV and the use of morphine or antiemetics. Postoperative hospitalization was a median of 1 day in the laxative group and of 2 days in the placebo group (P=.41).

Conclusion:

Laxative improves recovery of gastrointestinal function after fast-track hysterectomy but has no significant effect on pain and PONV.
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多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年——长海医院病例

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解放军第二军医大学附属长海医院内分泌科

 

患者为中年女性，35岁，因“多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年”于2008年8月入院。患者2007年感冒后出现多饮、多尿，每日饮水约10,000 ml，未予重视及诊治。2007年出现闭经，在外院妇产科就诊，先后予2次黄体酮肌肉注射，仍未来月经。半年前体重增加25 kg，肝区不适，肝功能示转氨酶升高。患者无便秘腹胀、无皮肤感染、无双下肢水肿，活动后稍感胸闷、气喘，夜尿增多，平均每小时1次。最大体重88.7 kg。既往史无特殊。月经史：初潮14岁，4/28～30，2008年6月。

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