Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing p

来源 :世界胃肠病学杂志(英文版) | 被引量 : 0次 | 上传用户:miclleg
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Perioperative glycemic control is important for reducing postoperative infectious complications. However,clinical trials have shown that efforts to maintain normoglycemia in intensive care unit patients result in deviation of glucose levels from the optimal range, and frequent attacks of hypoglycemia. Tight glycemic control is even more challenging in those undergoing pancreatic resection. Removal of lesions and surrounding normal pancreatic tissue often cause hormone deficiencies that lead to the destruction of glucose homeostasis, which is termed pancreatogenic diabetes. Pancreatogenic diabetes is characterized by the occurrence of hyperglycemia and iatrogenic severe hypoglycemia, which adversely effects patient recovery.Postoperatively, a variety of factors including surgical stress, inflammatory cytokines, sympathomimetic drug therapy, and aggressive nutritional support can also affect glycemic control. This review discusses the endocrine aspects of pancreatic resection and highlights postoperative glycemic control using a closed-loop system or artificial pancreas. In previous experiments,we have demonstrated the reliability of the artificial pancreas in dogs with total pancreatectomy, and its postoperative clinical use has been shown to be effective and safe, without the occurrence of hypoglycemic episodes, even in patients after total pancreatectomy.Considering the increasing requirement for tight perioperative glycemic control and the recognized risk of hypoglycemia, we propose the use of an artificial endocrine pancreas that is able to monitor continuously blood glucose concentrations with proven accuracy, and administer automatically substances to ret blood glucose concentration to the optimal narrow range.
其他文献
1型糖尿病发病率逐年上升,我国人口基数庞大,1型患者并不在少数.由于发病年龄轻、带糖生活时间长、急慢性并发症发生风险高等特点,1型糖尿病给患者、家庭及社会带来了沉重的
期刊
Iatrogenic bile duct injuries (IBDI) remain an important problem in gastrointestinal surgery. They are most frequently caused by laparoscopic cholecystectomy wh
In the past issues, the cases have been described in the infected diseases and antimicrobial therapy, it is useful and necessary that nonperiodic comprehension
The expression of Toll-like receptor 4 (TLR4) in neonatal cord blood mononuclear cells (MNCs) and serum TNF-α were investigated in order to explore the roles o
目的:观察新诊断2型糖尿病(T2DM)患者血脂比值的特点,并探讨短期胰岛素强化治疗对其影响.方法:入组90例新诊断T2DM患者及58例血糖正常对照者,测定两组的身高、体质量、血糖及
老年发病的糖尿病病情常常不太严重.但是,如果患者出现严重高血糖,应当检测有无心肌梗死,脑梗死等严重心血管并发症的危险.此外,应当注意患者运动状况,用药及生存环境有无改
2014年10月发表在《Diabetes Obes Metab》的一项英国研究,对一线单药治疗使用磺脲类药物或二甲双胍的患者全因死亡和主要不良心血管事件的风险进行了评估,结果发现与单用二
期刊
期刊
生病期间是指糖尿病患者患上感冒或流感等常见疾病的一段时间,可导致糖尿病患者进食减少.血糖难以控制.老年糖尿病患者高血糖和低血糖相关性症状常不明显,因此,生病期间应当
问:我每周六天,每天进行30分钟心肺锻炼,如果每次增加到60分钟,带来的好处是否也能翻倍?rn答:如果你想知道的是,将锻炼时长加倍是否也能令健康益处加倍,那么根据大多数指征来
期刊