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使用胰高血糖素样肽-1受体激动剂时进行上消化道内镜检查的临床结果与安全性

Clinical Outcomes and Safety of Upper Endoscopy While on Glucagon-Like Peptide-1 Receptor Agonists.

作者信息

Firkins Stephen A, Yates Joy, Shukla Neehal, Garg Rajat, Vargo John J, Lembo Anthony

机构信息

Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Community Care Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

出版信息

Clin Gastroenterol Hepatol. 2025 Apr;23(5):872-873.e3. doi: 10.1016/j.cgh.2024.03.013. Epub 2024 Apr 3.

Abstract

Glucose-like peptide-1-receptor agonists (GLP-1RAs) have become integral to the management of type 2 diabetes and obesity. GLP-1RAs work in part through delaying gastric emptying, raising concerns about retained gastric contents (RGC) during esophagogastroduodenoscopy (EGD). The American Society of Anesthesiologists currently recommends holding GLP-1RAs for 1 dosing cycle before elective procedures, however, the American Gastroenterological Association (AGA) advocates proceeding with endoscopy in asymptomatic patients adhering to standard perioperative protocols without medication withholding and suggests implementing a liquid diet the day before endoscopy in lieu of stopping the medication. This variability in recommendations stems largely from a lack of GLP-1RA outcomes data from which to draw evidence-based conclusions.

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RAs)已成为2型糖尿病和肥胖症管理的重要组成部分。GLP-1RAs部分通过延迟胃排空发挥作用,这引发了人们对食管胃十二指肠镜检查(EGD)期间胃内残留内容物(RGC)的担忧。美国麻醉医师协会目前建议在择期手术前停用GLP-1RAs一个给药周期,然而,美国胃肠病学会(AGA)主张在无症状患者中遵循标准围手术期方案进行内镜检查,无需停药,并建议在内镜检查前一天采用流食代替停药。这些建议的差异很大程度上源于缺乏GLP-1RAs的结果数据,无法从中得出基于证据的结论。

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