术前口服碳水化合物研究新进展  

Safety and benefits of preoperative supply of carbohydrates

作　　者：赵蕾 万勇[1] 李卫[2] 左友波[1] Zhao Lei;Wan Yong;Li Wei;Zuo Youbo(Department of Anesthesiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Pain,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]川北医学院附属医院麻醉科,南充637000 [2]绵阳市中心医院疼痛科,621000

出　　处：《国际麻醉学与复苏杂志》2018年第11期1059-1062,共4页International Journal of Anesthesiology and Resuscitation

基　　金：四川省教育厅自然科学基金一般项目(17ZB0179).

摘　　要：背景临床择期手术患者术前禁食、禁饮时间(>10h)较所需时间(4~6h)普遍偏长。基于术前长时间禁食、禁饮对患者术后康复与预后的影响,近年来术前禁食、禁饮得到了不断更新与发展。目的阐明术前口服碳水化合物(preoperative oral carbohydrate,POC)的安全性以及对患者术后快速康复的益处。内容术前口服适量含碳水化合物的清饮料,即POC可促进患者术后康复。研究显示POC减少手术过程中水分及能量的丢失,减轻术后不适(口渴与饥饿),维持体温,改善围手术期代谢,减轻应激等。术前口服的碳水化合物主要由麦芽糖、多聚糖、果糖、葡萄糖以及多种电解质组成,能迅速从胃排空,不引起反流误吸。此外,POC可减轻术后胰岛素抵抗以及炎症反应。趋向POC减轻术后胰岛素抵抗,维持机体水电解质平衡,促进患者术后康复。POC对术后并发症的影响还有待进一步研究。Background The preoperative fasting time before elective surgery is generally longer (>10h)than it should be (4-6h).Considering the impact of long preoperative fasting time on the health and prognosis of patients after surgery,the procedure has been recently updated.Objective To evaluate the safety and benefits of preoperative supply of carbohydrates in the terms of the rapidity of patients'recovery after surgery.Content Suitable amount of water soluble carbohydrate supply before operations, named preoperative oral carbohydrate (POC),promotes postoperative rehabilitation in patients.Accumulating evidence demonstrates that POC compensates the loss of water and energy throughout operations,relieves postoperative distress (thirsty and hungry), maintains body temperature,improves perioperative metabolism,and tackles stress,etc.Preoperative oral carbohydrates,composed of maltose,polysaccharide,fructose,glucose,and multiple minerals,can be rapidly emptied from the stomach,and does not lead to regurgitation.Additionally,POC alleviates postoperative insulin resistance and inflammation.Trend POC attenuates postoperative insulin resistance,maintains water-electrolyte-energy balance in the body,and promotes postoperative rehabilitation.Its benefits in postoperative complications need further investigations.

关 键 词：术前 碳水化合物 禁食禁饮 

分 类 号：R459.3[医药卫生—治疗学]