术前给予5%葡萄糖溶液后对老年人胃排空的内镜评估：一项随机对照研究。

Endoscopic assessment of gastric emptying in older adults after preoperative administration of 5% glucose solution: a randomized controlled study.

作者信息

Liu Yan, Yu Qian, Wang Run, Luo Linli

机构信息

Department of Anesthesiology, Chengdu Jinniu District People's Hospital (Sichuan Provincial People's Hospital Jinniu Hospital), 389#, the Huazhaobi Zhongheng Street, Jinniu District, Chengdu, Sichuan, 610041, China.

Department of Anesthesiology, Public Health Clinical Center of Chengdu, 18#, the Jingjusi Road, Jinjiang District, Chengdu, Sichuan, 610041, China.

出版信息

BMC Anesthesiol. 2024 Dec 19;24(1):458. doi: 10.1186/s12871-024-02847-5.

DOI:10.1186/s12871-024-02847-5

PMID:39695966

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11657266/

Abstract

BACKGROUND

Delayed gastric emptying of liquids may heighten the risk of aspiration reflux in elderly individuals. To investigate the gastric emptying of an oral supplement containing 5% dextrose solutions before sedation for gastroscopy.

PATIENTS AND METHODS

A total of 100 elderly patients who were scheduled for elective gastroscopy were randomly assigned to two groups: the NPO(nil per os ) group and the dextrose solution ingestion group, which ingested a 5% dextrose solution (5 ml/kg) two hours before the procedure. The primary outcome measure was the gastric volume (GV) suctioned and measured during the gastroscopic examination. Secondary outcome measures included GV per weight (GV/kg), post-discharge blood glucose levels, patient discomfort assessed using the Visual Analog Scale (VAS), clarity of gastric mucosal visualization during gastroscopy, and the incidence of adverse events. Additionally, linear regression analysis was employed to identify factors influencing gastric volume.

RESULTS

There were no significant differences in gastric volume (GV) (P=0.258) and GV per weight (GV/W) (P=0.137) between the NPO group and the dextrose solution group. However,the NPO group had higher discomfort scores on the Visual Analog Scale compared to the dextrose solution group, with a statistically significant difference(P<0.001). The clarity of gastric mucosal visualization during gastroscopy was also significantly different between the two groups(P=0.038). Blood glucose levels and the incidence of adverse events showed no significant differences between the two groups.Multivariate linear regression analysis revealed that younger age and higher functional dyspepsia symptom diary (FDSD) scores were associated with larger gastric volume, with the regression equation being: GV = 79.922 - 1.186 age + 0.556 FDSD.

CONCLUSION

In elderly patients, drinking 5 ml/kg of a 5 % glucose solution two hours prior to gastroscopy does not significantly increase gastric volume compared to midnight fasting.

TRIAL REGISTRATION

ChiCTR2100047031 (date of registration: 7 June 2021).

摘要

背景

液体胃排空延迟可能会增加老年人误吸反流的风险。本研究旨在调查胃镜检查镇静前口服含5%葡萄糖溶液的营养补充剂后的胃排空情况。

患者与方法

总共100例计划接受择期胃镜检查的老年患者被随机分为两组：禁食组和葡萄糖溶液摄入组，后者在检查前两小时摄入5%葡萄糖溶液（5 ml/kg）。主要观察指标是胃镜检查期间吸出并测量的胃内液体量（GV）。次要观察指标包括每千克体重的胃内液体量（GV/kg）、出院后血糖水平、使用视觉模拟评分法（VAS）评估的患者不适程度、胃镜检查时胃黏膜的可视清晰度以及不良事件的发生率。此外，采用线性回归分析来确定影响胃内液体量的因素。

结果

禁食组和葡萄糖溶液组在胃内液体量（GV）（P = 0.258）和每千克体重的胃内液体量（GV/W）（P = 0.137）方面无显著差异。然而，禁食组在视觉模拟评分法上的不适评分高于葡萄糖溶液组，差异具有统计学意义（P < 0.001）。两组在胃镜检查时胃黏膜的可视清晰度也存在显著差异（P = 0.038）。两组之间的血糖水平和不良事件发生率无显著差异。多因素线性回归分析显示，年龄较小和功能性消化不良症状日记（FDSD）评分较高与较大的胃内液体量相关，回归方程为：GV =79.922 - 1.186×年龄 + 0.556×FDSD。