Metro Health - University of Michigan Health System, Wyoming, MI, USA; Clinical Associate Professor Michigan State University College of Osteopathic Medicine, Department of Osteopathic Surgical Specialties, USA.
Professor, Vice Chair Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Am J Surg. 2018 Mar;215(3):373-376. doi: 10.1016/j.amjsurg.2017.10.029. Epub 2017 Nov 8.
Perioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program.
Retrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016-March 2017. Cohorts included simple (SIM) and complex carbohydrate (COM) groups. Statistical analysis was performed with linear and logarithmic regression.
83 patients were included (42 SIM, 41 COM). SIM group was older (61.7 vs 52.7 p = 0.012) Glycemic variability was less in the COM group (7.6% vs 21.4% P = 0.034). The frequency of hyperglycemia, postoperative complications, and length of stay trended higher in the SIM group.
This retrospective analysis identifies significant improvement in the perioperative glycemic variability with preoperative low dose complex carbohydrate loading compared to simple carbohydrate loading in colorectal surgery patients.
围手术期胰岛素抵抗与接受大手术的患者的高血糖相关发病率显著相关。我们试图评估与商业上可获得的运动饮料相比，术前给予低剂量麦芽糊精/瓜氨酸溶液对既定结直肠加速康复方案中血糖水平的影响。
回顾性分析了 2016 年 1 月至 2017 年 3 月期间接受择期非糖尿病结肠切除术和肠切除术的患者。队列包括简单（SIM）和复合碳水化合物（COM）组。采用线性和对数回归进行统计分析。
共纳入 83 例患者（SIM 组 42 例，COM 组 41 例）。SIM 组年龄更大（61.7 岁 vs 52.7 岁，P=0.012）。COM 组的血糖变异性更小（7.6% vs 21.4%，P=0.034）。SIM 组的高血糖发生率、术后并发症和住院时间呈上升趋势。
这项回顾性分析表明，与简单碳水化合物相比，术前给予低剂量复合碳水化合物可显著改善结直肠手术患者围手术期血糖变异性。
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