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GLP-1受体激活剂在胃肠内镜中的影响:更新的评论

Sahib Singh¹, Saurabh Chandan², Dushyant Singh Dahiya³

¹Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

Journal of clinical medicine

|September 28, 2024

概括

类似葡萄糖-1受体激动剂 (GLP-1 RAs) 可能会增加胃内含物留存的风险. 关于在手术前是否持有这些糖尿病和肥胖药物的指导方针有所不同,对于内镜手术需要更多的数据.

科学领域:

药理学和胃肠病学药理学和胃肠病学
临床麻醉学临床麻醉学

背景情况:

类似葡萄糖-1受体激动剂 (GLP-1RA) 广泛用于糖尿病和肥胖管理.
人们担心GLP-1RA对胃机动性的影响,以及在外科手术期间潜在的吸入风险.
主要医学协会的相互矛盾的建议凸显了对外科手术期间管理的清晰度的需要.

研究的目的:

审查当前关于GLP-1RA的术后使用的临床指南.
分析评估GLP-1RA对胃肠道内镜的影响现有研究.
提供关于在选修程序之前持有GLP-1RA的决策过程的见解.

主要方法:

审查美国麻醉学会 (ASA) 和美国胃肠道学会 (AGA) 等组织的当前临床指南.
综合了从回顾性和前性研究 (包括元分析) 中关于在接受内镜手术的患者中使用GLP-1RA的研究结果.
讨论有关GLP-1RA对肠道生理学影响的证据,与内镜相关.

主要成果:

美国医学会建议在选择性手术前停止使用GLP-1RA,而美国医学会建议在内镜检查时采用个性化的方法.
已发表的研究正在评估在内镜检查期间与GLP-1RA相关的胃内存和吸入的实际风险.
现有的数据仍在分析中,以最终指导GLP-1RA和GI内镜的临床实践.

结论:

在ASA和AGA指南之间存在差异,涉及到手术前GLP-1RA的管理.
进一步的研究是必不可少的,以澄清GLP-1RA在选择性肠道内镜的背景下安全概况.
基于证据的,个性化的方法对于管理正在接受内镜手术的GLP-1RA患者至关重要.

关键词:

囊内镜检查囊内镜检查结肠镜检查结肠镜检查葡萄糖类-1受体激动剂的葡萄糖类-1受体激动剂上部内镜上部内镜

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