Yang Jing, Wu Hao-Tian, Ma Ni, Wu Jia-Xing, Yang Min
Department of Pediatrics, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Aug 15;27(8):923-928. doi: 10.7499/j.issn.1008-8830.2412155.
To investigate the role of active glucose monitoring in preventing hypoglycemia during the perioperative period of gastrointestinal endoscopy in children with glycogen storage disease type Ⅰb (GSD-Ⅰb).
A retrospective analysis was performed for the clinical data of children with GSD-Ⅰb who were diagnosed and treated in Guangdong Provincial People's Hospital from June 2021 to August 2024. The effect of active glucose monitoring on hypoglycemic episodes during the perioperative period of gastrointestinal endoscopy was analyzed.
A total of 14 children with GSD-Ⅰb were included, among whom there were 7 boys and 7 girls, with a mean age of 10.0 years. Among 34 hospitalizations, there were 15 cases of hypoglycemic episodes (44%), among which 6 symptomatic cases (1 case with blood glucose level of 1.6 mmol/L and 5 cases with blood glucose level of <1.1 mmol/L) occurred without active monitoring, while 9 asymptomatic cases (with blood glucose level of 1.2-3.9 mmol/L) were detected by active monitoring. The predisposing factors for hypoglycemic episodes included preoperative fasting (5 cases, 33%), delayed feeding (7 cases, 47%), vomiting (2 cases, 13%), and parental omission (1 case, 7%). Two children experienced two hypoglycemic episodes during the same period of hospitalization, and no child experienced subjective symptoms prior to hypoglycemic episodes. Treatment methods included nasogastric glucose administration (1 case, 7%), intravenous injection of glucose (14 cases, 93%), and continuous glucose infusion (4 cases, 27%). Blood glucose returned to 3.5-6.9 mmol/L within 10 minutes after intervention and remained normal after dietary resumption.
Active glucose monitoring during the perioperative period of gastrointestinal endoscopy can help to achieve early detection of hypoglycemic states in children with GSD-Ⅰb, prevent hypoglycemic episodes, and enhance precise diagnosis and treatment.
探讨动态血糖监测在预防Ⅰb型糖原贮积病（GSD-Ⅰb）患儿胃肠镜检查围手术期低血糖中的作用。
回顾性分析2021年6月至2024年8月在广东省人民医院确诊并治疗的GSD-Ⅰb患儿的临床资料。分析动态血糖监测对胃肠镜检查围手术期低血糖发作的影响。
共纳入14例GSD-Ⅰb患儿，其中男7例，女7例，平均年龄10.0岁。34次住院中，发生低血糖发作15例（44%），其中6例有症状发作（1例血糖水平为1.6 mmol/L，5例血糖水平<1.1 mmol/L）在未进行动态监测时发生，而9例无症状发作（血糖水平为1.2 - 3.9 mmol/L）通过动态监测发现。低血糖发作的诱发因素包括术前禁食（5例，33%）、喂养延迟（7例，47%）、呕吐（2例，13%）和家长疏忽（1例，7%）。2例患儿在同一住院期间经历了2次低血糖发作，且无患儿在低血糖发作前出现主观症状。治疗方法包括鼻饲葡萄糖（1例，7%）、静脉注射葡萄糖（14例，93%）和持续葡萄糖输注（4例，27%）。干预后10分钟内血糖恢复至3.5 - 6.9 mmol/L，恢复饮食后血糖保持正常。
胃肠镜检查围手术期动态血糖监测有助于早期发现GSD-Ⅰb患儿的低血糖状态，预防低血糖发作，提高精准诊断和治疗水平。
