糖尿病(DM)患者的胃排空可能会延迟。然而,空腹糖尿病患者全胃的发生率和麻醉下肺吸入的风险尚不清楚.
进行了范围审查,以绘制有关DM误吸风险的文献。在七个书目数据库中进行了检索,包括MEDLINE和Embase,对于研究吸入风险的原始文章,胃排空,或胃内容物和体积。由两名独立的审阅者使用外部注册的预定义协议进行选择和表征。
搜索确定了5063条唯一记录,选择了16项研究(共775例DM患者):9项研究了胃排空,7项研究了胃内容物或体积。没有研究报告DM受试者误吸的发生率。所有9项研究都报告了DM患者与健康对照组相比的排空延迟。在比较围手术期的胃残余内容物/体积(GRV)的七项研究中,在DM患者和对照组中,有5例报道临床上可忽略不计的GRV,而两个观察到DM患者的“全胃”发生率较高。
关于DM手术患者误吸风险的证据是基于数量有限的研究,大部分是不失明的,报告胃排空和胃体积的生理数据作为误吸风险的替代指标。关于DM患者空腹胃内容物和体积的数据是有限且矛盾的;因此,空腹糖尿病患者误吸的真正风险尚不清楚.
Gastric emptying may be delayed in patients with diabetes mellitus (DM). However, the incidence of full stomach in fasting patients with DM and their risk of pulmonary aspiration under anaesthesia is not well understood.
A scoping
review was undertaken to map the literature on aspiration risk in DM. A search was conducted in seven bibliographic databases, including MEDLINE and Embase, for original articles that studied aspiration risk, gastric emptying, or gastric content and volume. Selection and characterisation were performed by two independent reviewers using a predefined protocol registered externally.
The search identified 5063 unique records, and 16 studies (totalling 775 patients with DM) were selected: nine studied gastric emptying and seven studied gastric content or volume. There were no studies reporting the incidence of aspiration in subjects with DM. All nine studies reported delayed emptying in patients with DM compared with healthy controls. Amongst the seven studies that compared gastric residual content/volume (GRV) in the perioperative period, five reported clinically negligible GRV in both patients with DM and controls, whereas two observed a higher incidence of \'full\' stomach in patients with DM.
The evidence concerning the aspiration risk for surgical patients with DM is based on a limited number of studies, mostly unblinded, reporting physiological data on gastric emptying and gastric volume as surrogate markers of aspiration risk. Data on fasting gastric content and volume in patients with DM are limited and contradictory; hence, the true risk of aspiration in fasting patients with DM is unknown.