术前过长的禁食禁饮时间会引起不必要的应激反应,导致患者产生口渴、饥饿、焦虑等不良主观感受。近年来,基于加速康复外科(enhanced recovery after surgery, ERAS)理念的广泛应用,术前口服碳水化合物已被证实是安全可行的,其不仅缓解患者的不良主观感受,还具有增加术后胰岛素敏感性、减少术后并发症、缩短住院时间等优势。但各类指南、建议等不推荐糖尿病患者实施该策略。文章拟对糖尿病术前口服碳水化合物的临床应用现状进行讨论总结,并对其安全性与可行性进行分析论述,为临床工作提供理论支撑。
Excessive preoperative fasting can cause unnecessary stress responses, which can lead to adverse subjective feelings such as thirst, hunger, and anxiety for patients. In recent years, preoperative oral carbohydrate has been proven to be safe and feasible based on the widespread application of the concept of enhanced recovery after surgery (ERAS). This strategy can not only alleviate patients’ adverse subjective feelings, but also has the advantages of increasing postoperative insulin sensi-tivity, reducing postoperative complications, and reducing length of hospital stay. However, most of the guidelines and recommendations do not recommend this strategy for diabetic patients. This re-view intends to discuss and summarize the clinical application status of preoperative oral carbohy-drates in patients with diabetes mellitus. The safety and feasibility of this strategy will be analyzed and discussed to provide theoretical basis for clinical practice.
禁食,碳水化合物,加速康复外科,糖尿病, Fasting Carbohydrate Enhanced Recovery after Surgery Diabetes Mellitus摘要
术前过长的禁食禁饮时间会引起不必要的应激反应,导致患者产生口渴、饥饿、焦虑等不良主观感受。近年来,基于加速康复外科(enhanced recovery after surgery, ERAS)理念的广泛应用,术前口服碳水化合物已被证实是安全可行的,其不仅缓解患者的不良主观感受,还具有增加术后胰岛素敏感性、减少术后并发症、缩短住院时间等优势。但各类指南、建议等不推荐糖尿病患者实施该策略。文章拟对糖尿病术前口服碳水化合物的临床应用现状进行讨论总结,并对其安全性与可行性进行分析论述,为临床工作提供理论支撑。
关键词
禁食,碳水化合物,加速康复外科,糖尿病
Advances in the Application of Preoperative Oral Carbohydrates in Patients with Diabetes Mellitus
Peng Li*, Zhen Jia
Anesthesiology Department, Qinghai University Affiliated Hospital, Xining Qinghai
Excessive preoperative fasting can cause unnecessary stress responses, which can lead to adverse subjective feelings such as thirst, hunger, and anxiety for patients. In recent years, preoperative oral carbohydrate has been proven to be safe and feasible based on the widespread application of the concept of enhanced recovery after surgery (ERAS). This strategy can not only alleviate patients’ adverse subjective feelings, but also has the advantages of increasing postoperative insulin sensitivity, reducing postoperative complications, and reducing length of hospital stay. However, most of the guidelines and recommendations do not recommend this strategy for diabetic patients. This review intends to discuss and summarize the clinical application status of preoperative oral carbohydrates in patients with diabetes mellitus. The safety and feasibility of this strategy will be analyzed and discussed to provide theoretical basis for clinical practice.
Keywords:Fasting, Carbohydrate, Enhanced Recovery after Surgery, Diabetes Mellitus
李 鹏,贾 珍. 术前口服碳水化合物在糖尿病患者中的应用进展Advances in the Application of Preoperative Oral Carbohydrates in Patients with Diabetes Mellitus[J]. 临床医学进展, 2023, 13(01): 547-554. https://doi.org/10.12677/ACM.2023.131080
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