术前口服碳水化合物对剖宫产术后加速康复的影响

doi:10.12280/gjfckx.20240649

摘要/Abstract

摘要：

术前口服碳水化合物是剖宫产术后加速康复（enhanced recovery after cesarean delivery，ERAC）的关键环节，其要求产妇在手术前2~3 h口服一种等渗复合碳水化合物溶液（含麦芽糖糊精、果糖、葡萄糖和牛磺酸等成分）。然而，其利弊影响在产妇这一特殊群体中一直备受争议。研究表明术前口服碳水化合物实现ERAC是涉及多个层面和角度的复杂过程，能够缓解产妇饥饿感、降低胰岛素抵抗、缩短肠功能恢复时间、预防术中低体温以及降低术后恶心和呕吐的发生，同时有利于减少新生儿并发症、促进母乳喂养，进而改善母婴结局。综述术前口服碳水化合物对ERAC的具体影响及其在ERAC过程中的作用机制，以期为ERAC的深入研究和临床应用提供理论支持。

关键词: 剖宫产术, 剖宫产术后加速康复, 碳水化合物, 饮食疗法, 胰岛素抵抗

Abstract:

Preoperative oral carbohydrate is a key component of enhanced recovery after cesarean delivery (ERAC). It requires women to take an isotonic complex carbohydrate solution (containing maltodextrin, fructose, glucose and taurine) orally 2 to 3 hours before surgery. However, its beneficial and harmful effects have been controversial in this particular group of women. Studies have shown that preoperative oral carbohydrate intake, as a complex process involving multiple levels and angles, can alleviate maternal hunger, reduce insulin resistance, shorten the recovery time of intestinal function, prevent intraoperative hypothermia and reduce the incidence of postoperative nausea and vomiting, and help to reduce neonatal complications, promote breastfeeding, and thus improve maternal and infant outcomes. The specific effects of preoperative oral carbohydrate on ERAC and its mechanism in ERAC process were reviewed in order to provide theoretical support for in-depth study and clinical application of ERAC.

Key words: Caesarean section, Enhanced recovery after cesarean delivery, Carbohydrates, Dietary therapy, Insulin resistance

席欣欣, 郭红, 黎姗, 冯邸, 刘朵朵. 术前口服碳水化合物对剖宫产术后加速康复的影响[J]. 国际妇产科学杂志, 2024, 51(6): 616-619.

XI Xin-xin, GUO Hong, LI Shan, FENG Di, LIU Duo-duo. Effect of Preoperative Oral Carbohydrate on Enhanced Recovery after Cesarean Section[J]. Journal of International Obstetrics and Gynecology, 2024, 51(6): 616-619.

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