不同的手术前碳水化合物负荷对胰岛素抵抗的不同方案:一个网络元分析
Wu Ping1, Zhai Jingbo2, Wang Shanshan3
1School of Graduate, Tianjin University of Traditional Chinese Medicine, No.10 Poyang Lake Road, Tuanbo New City West, Jinghai District, Tianjin, China.
术前碳水化合物负载 (PCL) 在降低术后胰岛素抵抗 (IR) 方面比禁食或安慰剂更有效. 在手术前3小时服用PCL,特别是在手术的上午,似乎是减轻IR的最佳方案.
科学领域:
- 代谢手术 代谢手术
- 营养支持 营养支持
- 临床营养学 临床营养学
背景情况:
- 术前碳水化合物负载 (PCL) 减轻术后胰岛素抵抗 (IR) 的有效性仍在争论中.
- 对于PCL的最佳碳水化合物剂量和时间尚未确立.
研究的目的:
- 评估PCL在减少术后IR方面的疗效.
- 为了确定最佳的PCL治疗方案来管理术后的IR.
主要方法:
- 随机对照试验的系统审查和网络元分析.
- 根据频率,时间和控制组对7种PCL疗法进行分类.
- 根据手术程序 (开放 vs. 腹腔镜) 和剂量 (高>45g vs. 低≤45g) 的亚组分析.
主要成果:
- 与禁食和安慰剂相比,手术前3小时服用PCL显著降低了IR.
- 在手术前3小时的单次手术前剂量被确定为最佳方案 (SUCRA=90.9%),在开放式 (SUCRA=93.7%) 和腹腔镜 (SUCRA=99.9%) 程序中有效.
- 在开放式手术中,低剂量的PCL是最有效的 (SUCRA=95.3%). 在腹腔镜手术中,高剂量的PCL显示出最佳的最高概率 (SUCRA=99.2%).
结论:
- 术前的碳水化合物负载比禁食或安慰剂更有利于缓解术后的胰岛素抵抗.
- 在手术前一天早上,特别是手术前3小时给PCL是开放式和腹腔镜手术中最有效的方案.
- 需要进一步的研究来澄清不同剂量的碳水化合物对术后IR的影响.
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