目的:分析术前口服碳水化合物对择期手术患儿围术期体验的影响。方法:计算机检索PubMed、Web of Science、Embase、The Cochrane Library、中国学术期刊全文数据库(CNKI)、万方数据库及维普中文期刊数据库中关于择期手术患儿术前采用口...目的:分析术前口服碳水化合物对择期手术患儿围术期体验的影响。方法:计算机检索PubMed、Web of Science、Embase、The Cochrane Library、中国学术期刊全文数据库(CNKI)、万方数据库及维普中文期刊数据库中关于择期手术患儿术前采用口服透明无渣液体的饮食管理方案的临床随机对照试验(RCT)并进行Meta分析。结果:共纳入7篇RCT,包括700例研究对象(干预组420例,对照组280例)。Meta分析结果显示术前口服碳水化合物的儿童术前饮食管理方案对术前胃内容物量和术后血糖没有影响,不会过度降低胃液pH值,能提高术中镇静水平,降低术后恶心呕吐发生率并改善胰岛素水平。结论:术前口服碳水化合物的儿童术前饮食管理方案具有一定的安全性和可行性,但在儿科领域的研究证据不充足,且各研究样本量、干预方法、时间和频次也存在差异,仍需要更多证据支持该方案在儿科的推广。展开更多
目的本研究的目的旨在了解择期肝癌手术患者术前口服碳水化合物的安全性及其对术后应激性高血糖及胰岛素抵抗的影响。方法 61例符合原发性肝癌患者入组,按照随机表法随机分为实验组和对照组。实验组的患者术前3小时口服10%的葡萄糖250 m...目的本研究的目的旨在了解择期肝癌手术患者术前口服碳水化合物的安全性及其对术后应激性高血糖及胰岛素抵抗的影响。方法 61例符合原发性肝癌患者入组,按照随机表法随机分为实验组和对照组。实验组的患者术前3小时口服10%的葡萄糖250 m L,对照组的患者则按照传统术前准备。比较2组患者术中胃液量及围手术期血糖、血胰岛素和稳态模型的胰岛素抵抗指数(HOMA-IR)的变化情况。结果两组患者均未见1例误吸发生。实验组和对照组的胃液量分别为45.4±18.4 m L和38.8±17.2 m L,差异未见显著的统计学意义。两组患者术前的一般资料、肝功能、血糖、胰岛素和HOMA-IR水平相近。尽管术后第5天两组患者的肝功能指标相近,但研究组术后第1天和第3天的AST、ALT和总胆红素水平明显低于对照组;而且研究组的患者术后第1天、第3天和第5天的空腹血糖、胰岛素和HOMA-IR水平均明显低于对照组,差异具有统计学意义。结论本研究发现术前3小时口服10%的葡萄糖250 m L安全可靠,并显著降低术后应激性高血糖和胰岛素抵抗的发生。展开更多
Objectives: Hypoglycemia is a recognized danger in pediatric patients. Extended period of preoperative fasting in this subset of patients is not well tolerated with metabolic derangements. The oral carbohydrate loadin...Objectives: Hypoglycemia is a recognized danger in pediatric patients. Extended period of preoperative fasting in this subset of patients is not well tolerated with metabolic derangements. The oral carbohydrate loading preoperatively can ameliorate many adverse effects. The aim of this study was to compare the glycemic profile in pediatric cardiac surgical patients kept fasting preoperatively with those fed oral clear solutions of carbohydrate half hour prior to induction of anaesthesia. Also we tried to establish a correlation with other factors contributing to preoperative hypoglycemia. Methodology: We planned a randomized controlled study. Group A included patients who were kept fasting according to the ASA guidelines preoperatively and Group B included patients who received 2 ml per kg of body weight of 10% Dextrose water as oral feeds half hour before the expected time of start of anaesthesia. Results: The mean (SD) preoperative BG concentrations were higher in group B (102.5 ±16.97) as compared to group A (64.08 ± 25.37) (p value -0.86 and -0.67) (pvalue Conclusion: Preoperative oral carbohydrate preloading can develop as the easiest and cheapest path to better perioperative blood glucose concentration management in congenital cardiac disease children.展开更多
The effect of oral L-ornithine hydrochloride (0.1 g/kg BW) on energy expenditure during a rest period from 120 to 180 min after resistance exercise was evaluated by indirect calorimetry. Healthy male subjects who have...The effect of oral L-ornithine hydrochloride (0.1 g/kg BW) on energy expenditure during a rest period from 120 to 180 min after resistance exercise was evaluated by indirect calorimetry. Healthy male subjects who have no habit of resistance training underwent resistance exercise (chest press, lat pulldown, leg press, shoulder press, leg extension, and leg curl), with 3 sets of each exercise and 10 repetitions in each set at 90-s intervals, 30 min after ingestion of ornithine or placebo. Plasma ornithine levels immediately after, and 120 and 180 min after, resistance exercise were significantly greater after ingestion of ornithine than of placebo (Treatment: F = 347.1, P p2 = 0.95;Interaction: F = 160.7, P p2 = 0.95), but no significant difference in serum growth hormone levels was observed between the two treatments (Treatment: F = 0.1, P = 0.751, ηp2 = 0.01;Time: F = 1.7, P = 0.229, ηp2 = 0.16;Interaction: F = 2.4, P = 0.155, ηp2 = 0.21). Although there was no between-treatment difference in energy expenditure during the rest period 120 to 180 min after resistance exercise (Treatment: F = 0.1, P = 0.718, ηp2 = 0.02;Time: F = 0.1, P = 0.767, ηp2 = 0.01;Interaction: F = 0.1, P = 0.112, ηp2 = 0.26), with ornithine ingestion carbohydrate oxidation was significantly greater than with placebo from 170 to 180 min after exercise (Treatment: F = 0.8, P = 0.383, ηp2 = 0.09;Time: F = 9.7, P = 0.013, ηp2 = 0.52;Interaction: F = 5.8, P = 0.039, ηp2 = 0.39). Moreover, 180 min after exercise, serum free fatty acid levels after ornithine ingestion were lower than after placebo (Treatment: F = 0.3, P = 0.602, ηp2 = 0.03;Time: F = 34.6, P p2 = 0.79;Interaction: F = 5.6, P = 0.042, ηp2 = 0.38). A similar trend in 3-hydroxybutylate was observed. In conclusion, ornithine ingestion before resistance exercise may enhance post-exercise carbohydrate oxidation without changing total energy expenditure.展开更多
文摘目的:分析术前口服碳水化合物对择期手术患儿围术期体验的影响。方法:计算机检索PubMed、Web of Science、Embase、The Cochrane Library、中国学术期刊全文数据库(CNKI)、万方数据库及维普中文期刊数据库中关于择期手术患儿术前采用口服透明无渣液体的饮食管理方案的临床随机对照试验(RCT)并进行Meta分析。结果:共纳入7篇RCT,包括700例研究对象(干预组420例,对照组280例)。Meta分析结果显示术前口服碳水化合物的儿童术前饮食管理方案对术前胃内容物量和术后血糖没有影响,不会过度降低胃液pH值,能提高术中镇静水平,降低术后恶心呕吐发生率并改善胰岛素水平。结论:术前口服碳水化合物的儿童术前饮食管理方案具有一定的安全性和可行性,但在儿科领域的研究证据不充足,且各研究样本量、干预方法、时间和频次也存在差异,仍需要更多证据支持该方案在儿科的推广。
文摘目的本研究的目的旨在了解择期肝癌手术患者术前口服碳水化合物的安全性及其对术后应激性高血糖及胰岛素抵抗的影响。方法 61例符合原发性肝癌患者入组,按照随机表法随机分为实验组和对照组。实验组的患者术前3小时口服10%的葡萄糖250 m L,对照组的患者则按照传统术前准备。比较2组患者术中胃液量及围手术期血糖、血胰岛素和稳态模型的胰岛素抵抗指数(HOMA-IR)的变化情况。结果两组患者均未见1例误吸发生。实验组和对照组的胃液量分别为45.4±18.4 m L和38.8±17.2 m L,差异未见显著的统计学意义。两组患者术前的一般资料、肝功能、血糖、胰岛素和HOMA-IR水平相近。尽管术后第5天两组患者的肝功能指标相近,但研究组术后第1天和第3天的AST、ALT和总胆红素水平明显低于对照组;而且研究组的患者术后第1天、第3天和第5天的空腹血糖、胰岛素和HOMA-IR水平均明显低于对照组,差异具有统计学意义。结论本研究发现术前3小时口服10%的葡萄糖250 m L安全可靠,并显著降低术后应激性高血糖和胰岛素抵抗的发生。
文摘Objectives: Hypoglycemia is a recognized danger in pediatric patients. Extended period of preoperative fasting in this subset of patients is not well tolerated with metabolic derangements. The oral carbohydrate loading preoperatively can ameliorate many adverse effects. The aim of this study was to compare the glycemic profile in pediatric cardiac surgical patients kept fasting preoperatively with those fed oral clear solutions of carbohydrate half hour prior to induction of anaesthesia. Also we tried to establish a correlation with other factors contributing to preoperative hypoglycemia. Methodology: We planned a randomized controlled study. Group A included patients who were kept fasting according to the ASA guidelines preoperatively and Group B included patients who received 2 ml per kg of body weight of 10% Dextrose water as oral feeds half hour before the expected time of start of anaesthesia. Results: The mean (SD) preoperative BG concentrations were higher in group B (102.5 ±16.97) as compared to group A (64.08 ± 25.37) (p value -0.86 and -0.67) (pvalue Conclusion: Preoperative oral carbohydrate preloading can develop as the easiest and cheapest path to better perioperative blood glucose concentration management in congenital cardiac disease children.
文摘The effect of oral L-ornithine hydrochloride (0.1 g/kg BW) on energy expenditure during a rest period from 120 to 180 min after resistance exercise was evaluated by indirect calorimetry. Healthy male subjects who have no habit of resistance training underwent resistance exercise (chest press, lat pulldown, leg press, shoulder press, leg extension, and leg curl), with 3 sets of each exercise and 10 repetitions in each set at 90-s intervals, 30 min after ingestion of ornithine or placebo. Plasma ornithine levels immediately after, and 120 and 180 min after, resistance exercise were significantly greater after ingestion of ornithine than of placebo (Treatment: F = 347.1, P p2 = 0.95;Interaction: F = 160.7, P p2 = 0.95), but no significant difference in serum growth hormone levels was observed between the two treatments (Treatment: F = 0.1, P = 0.751, ηp2 = 0.01;Time: F = 1.7, P = 0.229, ηp2 = 0.16;Interaction: F = 2.4, P = 0.155, ηp2 = 0.21). Although there was no between-treatment difference in energy expenditure during the rest period 120 to 180 min after resistance exercise (Treatment: F = 0.1, P = 0.718, ηp2 = 0.02;Time: F = 0.1, P = 0.767, ηp2 = 0.01;Interaction: F = 0.1, P = 0.112, ηp2 = 0.26), with ornithine ingestion carbohydrate oxidation was significantly greater than with placebo from 170 to 180 min after exercise (Treatment: F = 0.8, P = 0.383, ηp2 = 0.09;Time: F = 9.7, P = 0.013, ηp2 = 0.52;Interaction: F = 5.8, P = 0.039, ηp2 = 0.39). Moreover, 180 min after exercise, serum free fatty acid levels after ornithine ingestion were lower than after placebo (Treatment: F = 0.3, P = 0.602, ηp2 = 0.03;Time: F = 34.6, P p2 = 0.79;Interaction: F = 5.6, P = 0.042, ηp2 = 0.38). A similar trend in 3-hydroxybutylate was observed. In conclusion, ornithine ingestion before resistance exercise may enhance post-exercise carbohydrate oxidation without changing total energy expenditure.
