How Jeffrey A, Siedel Jean Hansen, Shafer Aaron
Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX 77030, USA.
Gynecol Oncol Rep. 2021 Feb 4;36:100714. doi: 10.1016/j.gore.2021.100714. eCollection 2021 May.
Gastroparesis is a syndrome of delayed gastric emptying associated with nausea, vomiting, and postprandial fullness. Despite multiple etiologies, diabetes is one of the principal causes of gastroparesis. This case report examines a 57 year-old woman with poorly controlled diabetes type II (HbA1c 8.3%) complicated by diabetic nephropathy who was readmitted for gastroparesis after two days following uncomplicated robotic surgical staging for endometrial cancer. Prior to the procedure, the patient had received carbohydrate loading in accordance with our center's enhanced recovery pathway; this resulted in severe acute hyperglycemia, a recognized cause of gastroparesis in women with diabetes. During her readmission, she improved with bowel rest and optimization of glycemic control. This case suggests that routine pre-operative carbohydrate loading should be used with caution in poorly controlled diabetic patients.
胃轻瘫是一种与恶心、呕吐和餐后饱胀感相关的胃排空延迟综合征。尽管病因多样，但糖尿病是胃轻瘫的主要病因之一。本病例报告研究了一名57岁的2型糖尿病控制不佳（糖化血红蛋白8.3%）且并发糖尿病肾病的女性患者，该患者在子宫内膜癌的无并发症机器人手术分期两天后因胃轻瘫再次入院。在手术前，患者按照我们中心的强化康复方案接受了碳水化合物负荷；这导致了严重的急性高血糖，这是糖尿病女性发生胃轻瘫的一个公认原因。在她再次入院期间，通过肠道休息和血糖控制的优化，她的病情有所改善。该病例表明，对于控制不佳的糖尿病患者，应谨慎使用常规术前碳水化合物负荷。
