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术前口服碳水化合物对腹腔镜胆囊切除术患者胰岛素耐药性的影响:一项随机对照试验
Xiaohan Wang1, Jingwen Zhuang1, Jianxin Cheng1
1Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
Langenbeck's archives of surgery
|February 27, 2024
概括
手术前的口服碳水化合物没有影响胰岛素耐药性或胃排空在经过腹腔镜胆固醇切除术的患者. 摄入400毫升碳水化合物可以减少饥饿和口渴,而不会改变关键的代谢标志物.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 代谢医学是一种代谢医学.
背景情况:
- 术前禁食协议是选择性手术的标准.
- 口服碳水化合物负载正在探索减轻手术压力和提高患者舒适度.
- 关于特定的手术前口服碳水化合物 (POC) 量对腹腔镜胆囊切除术 (LC) 中代谢和胃参数的影响的数据有限.
研究的目的:
- 研究两种不同的手术前口服碳水化合物 (POC) 量对胰岛素抵抗 (IR) 和胃空化的影响.
- 为了在接受选择性腹腔镜胆囊切除术 (LC) 的患者中比较这些效应.
主要方法:
- 接受选择性LC的129名患者被随机分为三个组:控制组 (禁食),200毫升POC和400毫升POC,在手术前2-4小时服用.
- 测量了禁食血糖,胰岛素和葡萄糖水平,并使用恒温模型评估计算了IR.
- 通过超声波评估胃体积,并记录主观舒适度 (饥饿,口渴) 的得分.
主要成果:
- 两组之间没有观察到对胰岛素抵抗或胃体积的显著影响.
- 与其他组相比,400毫升的POC组显示了1级胃含量 (Perlas分级) 的更高流行率.
- 与对照组相比,400毫升的POC组报告说,与对照组相比,饥饿和口渴明显减少.
结论:
- 在手术前给予200毫升或400毫升的碳水化合物不会显著改变胰岛素抵抗或胃体积的LC患者.
- 虽然没有影响代谢或胃参数,但较大的碳水化合物量可以通过减少饥饿和口渴来改善手术前患者的舒适度.
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