肥胖和糖尿病患者在术后康复室使用GLP-1主动剂的脉冲氧计脱:一项回顾性观察性研究
Kimberly L Skidmore1, Hong Le1, Veronica Segredo2
1Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus
|August 12, 2025
概括
葡萄糖类-1 (GLP-1) 保持时间对糖尿病患者的术后氧气水平或葡萄糖没有影响. 然而,病态肥胖与显著氧气不和 (DSpO2) 的风险增加有关.
科学领域:
- 麻醉学和外科手术期间的医学.
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 葡萄糖类-1 (GLP-1) 激动剂用于糖尿病和肥胖症,可能会延迟胃排空.
- GLP-1治疗持续时间对术后结果的影响,特别是呼吸道并发症和血糖控制,需要进行调查.
- 致病性肥胖是术后并发症的一个独立风险因素.
研究的目的:
- 为了研究GLP-1保持时间和手术后氧气脱度 (DSpO2) 之间的关联,作为阿特莱克塔斯或微吸的标记.
- 为了确定GLP-1的持久时间是否会影响正在接受手术的糖尿病患者的禁食葡萄糖水平.
- 在这个患者群体中检查病态肥胖和DSpO2之间的关系.
主要方法:
- 对107名糖尿病患者 (18-80岁) 的回顾性观察队列研究,在30天内接受GLP-1,接受泌尿外科门诊手术.
- 患者根据GLP-1持久时间 (≤7天 vs>7天) 和病态肥胖 (BMI>35 kg/m2与主要并发症) 的存在来分类.
- 测量结果包括DSpO2 (手术前和手术后脉冲氧计的差异) 和空腹葡萄糖水平.
主要成果:
- 在短期和长期GLP-1持有组之间,没有发现DSpO2 (1.5%与1.8%) 或禁食葡萄糖 (130 mg/dL与138 mg/dL) 的显著差异.
- 患有病态肥胖症的患者与没有 (1.43%,p=0.0254) 的患者相比,显著增加了DSpO2 (2.29%).
- 在患有病态肥胖症的患者中观察到DSpO2>4%的发病率增加的趋势 (24%对12%).
结论:
- 在接受户外泌尿外科手术的糖尿病患者中,GLP-1保持时间似乎不是DSpO2或禁食葡萄糖的重要因素.
- 致病性肥胖与手术后氧气脱的风险更高有关.
- 在GLP-1上患有致病性肥胖症和糖尿病的患者中,考虑进行内内管输入,以保护呼吸道,特别是在断层切除位置上,可能是谨慎的.
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