[GLP1-激动剂和SGLT2抑制剂在外科环境中]
Ayla Y Stobbe1, Maartina J P Oosterom-Eijmael2,3, Bastiaan E de Galan4
1Amsterdam UMC, Amsterdam. Afd. Anesthesiologie.
Nederlands tijdschrift voor geneeskunde
|June 12, 2025
概括
在手术期间长期使用GLP1-激动剂和SGLT2抑制剂可能是安全的. 持续使用可以防止葡萄糖失调,并对SGLT2抑制剂进行特殊监测.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 在外科手术期间的医学.
背景情况:
- 葡萄糖类-1 (GLP1) 受体激素剂和-葡萄糖共运输体-2 (SGLT2) 抑制剂越来越多地用于住院患者的代谢,心血管和的好处.
- 由于GLP1-激动剂 (吸收风险) 的胃排空延迟和SGLT2抑制剂的euglycemic酸性,存在关于外科手术期间安全性的担忧.
- 目前的指导方针建议在手术前停止GLP1-激动剂的一剂和SGLT2抑制剂三天,可能导致葡萄糖失调.
研究的目的:
- 评估持续使用GLP1-激动剂和SGLT2抑制剂的术后安全性.
- 提出关于在外科手术过程中管理这些药物的最新建议.
- 为了减轻与手术前停药相关的葡萄糖失调风险.
主要方法:
- 对GLP1激素对长期使用胃空化的作用现有文献的综述.
- 分析与使用SGLT2抑制剂和术后葡萄糖管理策略相关的风险.
- 根据药理性质和患者群体制定建议.
主要成果:
- GLP1-激动剂对胃空化的作用似乎随着长期使用而减弱,这表明继续服用可能是安全的.
- 在2型糖尿病患者中,SGLT2抑制剂可能可以安全地继续与外科手术期间的葡萄糖和胰岛素治疗.
- 在继续服用SGLT2抑制剂时,建议对非糖尿病患者进行血气测量,这些患者有酸性的风险.
结论:
- 长期GLP1-激动剂可以安全地在外科手术期间继续使用,这挑战了当前的指导方针.
- 通过适当的葡萄糖和胰岛素管理,可以安全地继续使用SGLT2抑制剂,特别是在2型糖尿病患者中.
- 需要修订术后管理策略,以优化患者安全和血糖控制.
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