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手术后更好的康复:在2型糖尿病患者手术前增加碳水化合物和胰岛素管理
Cindy Bredefeld1,2, Amy Patel1, Shahidul Islam3
1Department of Medicine, New York University Long Island School of Medicine, NYU Langone Hospital-Long Island, 101 Mineola Blvd, Mineola, NY 11501, USA.
Surgery open science
|March 11, 2024
概括
在2型糖尿病患者在手术后增强恢复 (ERAS) 协议中,在手术前碳水化合物负载 (CHO-L) 之前进行个性化胰岛素剂量是安全的和可行的. 这种方法有效地控制了手术前的血糖水平,而不会导致低血糖症.
科学领域:
- 内分泌学 在内分泌学.
- 在外科手术期间的医学.
- 糖尿病管理 糖尿病管理
背景情况:
- 手术后增强恢复 (ERAS) 协议优化了患者的康复.
- 碳水化合物负载 (CHO-L) 在ERAS中使用,但可以提高手术前的葡萄糖.
- 2型糖尿病患者在外科手术期间需要谨慎的葡萄糖管理.
研究的目的:
- 在ERAS协议中评估在2型糖尿病患者中CHO-L之前个性化胰岛素剂量的安全性和可行性.
- 评估这一策略对手术前血糖控制的影响.
- 为非专业提供者提供胰岛素剂量算法.
主要方法:
- 对机构实践的回顾性评估.
- 患有2型糖尿病的患者在50g CHO-L之前接受了快速起作用的胰岛素 (胰岛素阿斯巴特).
- 在手术前进行了点照顾 (POC) 血糖监测.
主要成果:
- 在CHO-L和胰岛素后没有观察到低血糖事件.
- 手术前的POC葡萄糖值在6.8至12.3毫摩尔/升 (123-221毫克/分升) 之间.
- 该策略成功地减轻了CHO-L的高血糖效应.
结论:
- 在CHO-L之前的个性化胰岛素剂量是ERAS协议中2型糖尿病患者的可行和安全的策略.
- 这种方法有效地管理手术前的血糖,防止低血糖.
- 这项研究提出了一个实用的胰岛素剂量算法,用于更广泛的临床应用.
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