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在外科手术或内镜手术前,我们是否应该停止使用类似葡萄糖类-1受体激活剂? 将有限的证据与临床判断相平衡

Guillermo Umpierrez¹, Francisco J Pasquel¹, Elizabeth Duggan²

¹Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.

Journal of diabetes science and technology

|March 11, 2024

概括

美国麻醉学会建议在手术前停止使用类似葡萄糖-1受体激动剂 (GLP-1 RA) 由于吸入风险. 然而,这可能会使血糖控制恶化,需要进一步研究和多学科方法.

科学领域:

麻醉学麻醉学
内分泌学在内分泌学.
药理学药理学是指药理学的学科.

背景情况:

美国麻醉学会 (ASA) 特别工作组建议在手术前停止使用类似葡萄糖-1受体激动剂 (GLP-1 RA) 药物.
这一建议源于对肺吸气的潜在风险的担忧.
然而,支持这一准则的科学证据有限,并且拒绝GLP-1RA可能会对糖尿病患者的血糖控制产生负面影响.

研究的目的:

评估ASA建议在手术前停止GLP-1RA的有限科学证据.
突出 GLP-1 RA 治疗对糖尿病患者血糖控制的潜在不良影响.
为接受选择性手术的GLP-1RA患者提出替代的多学科管理策略.

主要方法:

关于GLP-1RA使用,肺吸气风险和外科手术期间血糖控制的当前科学文献的综述.
在糖尿病管理的背景下,分析停止GLP-1RA的影响.
制定多学科方法的建议,等待进一步的安全数据.

主要成果:

目前,有限的科学证据支持ASA的建议,由于吸收风险,停止GLP-1RA.
停止GLP-1 RA治疗可能会导致糖尿病患者的低最佳血糖控制.
需要进一步的研究,包括观察和前性研究,以澄清风险和益处.

结论:

目前建议在手术前停止GLP-1RA,但缺乏强有力的科学支持.
建议采用多学科的方法来管理接受选择性手术的GLP-1RA患者.
进一步的研究是必要的,以确定肺吸收的实际风险和对血糖控制的影响,当GLP-1RA在外科手术期间举行.

关键词:

吸入性肺炎是一种肺炎.糖尿病并发症糖尿病并发症胃排空胃的排空印克雷丁剂是使用印克雷丁剂的.

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