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术前的碳水化合物负载,以减少术后的血糖变化和改善外科手术结果:一个范围审查
Robert Canelli1, Joseph Louca2, Ciana Hartman3
1Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States. robert.canelli@bmc.org.
World journal of diabetes
|June 29, 2023
概括
手术前的碳水化合物负载可能会降低血糖的变化和手术并发症,即使是糖尿病患者. 需要进一步的研究来标准化碳水化合物负载协议,以获得最佳的患者结果.
科学领域:
- 麻醉学 麻醉学
- 内分泌学 在内分泌学.
- 外科手术的结果
背景情况:
- 术后高血糖和血糖变化 (GV) 与不良结果有关.
- 长时间的禁食会增加GV和代谢,造成手术风险.
- 急性葡萄糖波动比慢性高血糖症更容易导致内皮功能障碍.
研究的目的:
- 审查关于手术前碳水化合物负载 (PCL) 和外科手术期间GV的证据.
- 评估PCL对手术结果的影响,特别是糖尿病患者.
- 探索GV的临床相关性及其与术后并发症的联系.
主要方法:
- 对13篇选定的文章进行范围审查.
- 对PCL对GV和手术结果的影响证据的分析.
- 专注于糖尿病患者.
主要成果:
- 初步证据表明PCL可能会减少GV并减轻葡萄糖峰值.
- PCL可能会降低术后发病率和死亡率风险.
- 对于大多数患者来说,PCL的好处似乎超过了风险,包括2型糖尿病患者.
结论:
- PCL显示出在最小化像GV这样的外科手术期间代谢障碍方面的潜力.
- 标准化PCL含量,体积和时间是至关重要的.
- 需要进一步的数据驱动的共识,以获得最佳的PCL管理协议.
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