在儿科手术中进行手术前的碳水化合物负载:对当前临床试验的全面审查
Yunita Widyastuti1, Djayanti Sari1, Anisa Fadhila Farid1
1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Public Health and Nursing, Dr. Sardjito General Hospital, Gadjah Mada University, Yogyakarta, Special Region of Yogyakarta, Indonesia.
F1000Research
|February 14, 2025
概括
在儿科手术中,手术前的碳水化合物负载 (PCL) 可以稳定血糖并降低代谢风险. 然而,关于住院时间和术后并发症的证据需要进一步研究.
科学领域:
- 儿科手术 儿科手术
- 手术后增强恢复 (ERAS) 协议
- 营养支持 营养支持
背景情况:
- 手术前碳水化合物负载 (PCL) 是手术后增强恢复 (ERAS) 协议的一个组成部分.
- 它涉及在手术前给予富含碳水化合物的液体,与传统的禁食形成鲜明对比.
- PCL旨在改善血糖控制,减轻胰岛素抵抗,并提高患者的舒适度.
研究的目的:
- 在儿科手术中对PCL进行全面的范围审查.
- 综合有关儿科患者PCL代谢和外科期结局的证据.
主要方法:
- 使用主要科学数据库 (PubMed,CINAHL,EMBASE,Cochrane,Scopus,Web of Science) 进行了系统范围审查.
- 包括在2017年至2024年期间发表的研究,重点是儿童群体的英语临床试验.
- 数据提取的重点是样本大小,PCL干预的类型和术后结果.
主要成果:
- 对儿科手术中PCL的11项研究进行了审查,参与者人数从18人到1200人.
- 七项研究报告说,血糖水平稳定,降低了低血糖风险.
- 五项研究表明,手术前的焦虑,兴奋和不适减少了;五项研究还指出,胃残留体积和pH值有所改善.
- 手术后的结果是混合的,四项研究中恶心/吐没有显著差异,而三项研究显示住院时间没有变化.
结论:
- 儿科手术中的PCL显示出稳定血糖和改善代谢概况的潜力.
- 目前,关于住院时间和术后并发症的好处的证据不一致.
- 需要进一步的研究来澄清PCL对这些关键恢复参数的影响.
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