葡萄糖类-1受体激动剂和周围过程吸收风险
Cindy N Ho1, Alessandra T Ayers1, Michael A Kohn2
1Diabetes Technology Society, Burlingame, CA 94010, USA.
Journal of the Endocrine Society
|September 2, 2025
概括
葡萄糖类-1受体激活剂 (GLP-1RAs) 似乎不会增加手术或内镜期间的吸收风险. 最近的研究显示GLP- 1RA使用与吸入性肺炎之间没有一致的联系,支持在手术前继续使用.
科学领域:
- 麻醉学
- 胃肠病学
- 药理学
背景情况:
- 由于GLP-1RAs的延迟胃排空,人们担心在手术期间的吸入风险.
- 美国麻醉学会 (ASA) 最初建议在手术前停止使用GLP-1RA,但后来改变了这一建议.
- 本审查审查了支持或反驳最初的ASA建议的证据.
研究的目的:
- 系统地审查GLP-1RA使用与吸收风险之间的相关证据.
- 在选择性手术和内镜手术之前评估持续使用GLP- 1RA的安全性.
主要方法:
- 对回顾性队列研究进行系统审查.
- 在PubMed搜索了2023年6月至2025年3月间发表的研究.
- 在GLP-1RA使用者和非使用者之间计算了吸入/肺炎的总结风险比率.
主要成果:
- 选择性手术的三项研究显示风险比为1. 00 [0. 76, 1. 30].
- 在四项内镜手术研究中,综合风险比为1. 10 [0. 95, 1. 27].
- 一项并行分析证实该方法可以检测阿片类药物使用的风险增加 (RR 2.68 [1.89, 3.81]).
结论:
- 尽管GLP-1RA会导致胃空气的延迟,但并未始终与吸血风险的增加有关.
- 实际证据不支持GLP-1RA与手术或内镜手术相关的显著吸收风险.
- 大多数患者可能会在选择性手术前继续GLP- 1RA治疗.
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