术前口服碳水化合物对围术期肿瘤患者的影响  

Impact of preoperative oral carbohydrate on patients with cancer in perioperative period

作　　者：韩金玉(综述) 张霄蓓(综述) 王准(综述) 王凯元(审校) Jinyu Han;Xiaobei Zhang;Zhun Wang;Kaiyuan Wang(Department of Anesthesiology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin's Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院麻醉科,国家肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津市300060

出　　处：《中国肿瘤临床》2024年第20期1049-1053,共5页Chinese Journal of Clinical Oncology

基　　金：天津市医学重点学科(与科)建设项目(编号:TJYXZDXK-009A)资助。

摘　　要：术前口服碳水化合物(preoperative oral carbohydrate,POC)作为加速康复外科(enhanced recovery after surgery,ERAS)的一部分,在现代麻醉和外科领域发挥了重要作用。POC可以减轻患者的术前焦虑,改善代谢状态,并能减轻术后胰岛素抵抗,减少应激反应和炎性反应,从而减少术后并发症的发生。针对肿瘤患者这一特殊人群,POC对其代谢、免疫功能、术后并发症甚至肿瘤复发的影响受到越来越多的关注。POC对肿瘤本身的直接影响尚未明确,合理的摄入可能通过调节机体代谢,增强免疫功能等间接途径对肿瘤的发展产生一定的抑制作用。本文就POC对肿瘤患者围术期的影响进行综述,以期为肿瘤患者术前准备提供理论基础。Preoperative oral carbohydrates(POC)play an important role in modern anesthesia and surgery as part of enhanced recovery after surgery(ERAS).Oral carbohydrate intake before surgery can reduce preoperative anxiety,improve metabolic status,reduce postoperative insulin resistance,and reduce stress and inflammatory responses in patients,thereby reducing the occurrence of postoperative complications.Directed at a specific population of patients with tumors,an increasing number of studies are focusing on the effects of oral carbohydrate intake before surgery on metabolism,immune function,postoperative complications,and even tumor recurrence.Notably,the direct effect of POC intake on the tumor itself remains unclear.Previous studies have suggested that a reasonable intake of carbohydrates may exhibit an inhibitory effect on tumor development through indirect mechanisms,such as regulating body metabolism and enhancing immune function.This review summarizes and analyzes the perioperative effects of preoperative carbohydrate load in patients with cancer and provides a theoretical basis for the preoperative preparation of these patients.

关 键 词：术前口服碳水化合物 肿瘤 围术期 胰岛素抵抗 

分 类 号：R730.5[医药卫生—肿瘤]