The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clin...The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clinical settings.It is now appreciated that acute BGC spikes,hypoglycemia,and high glycemic variability(GV)lead to more endothelial dysfunction and oxidative stress than uncomplicated,chronically elevated BGC.In the perioperative setting,fasting is the primary approach to reducing the risk for pulmonary aspiration;however,prolonged fasting drives the body into a catabolic state and therefore may increase GV.Elevated GV in the perioperative period is associated with an increased risk for postoperative complications,including morbidity and mortality.These challenges pose a conundrum for the management of patients typically instructed to fast for at least 8 h before surgery.Preliminary evidence suggests that the administration of an oral preoperative carbohydrate load(PCL)to stimulate endogenous insulin production and reduce GV in the perioperative period may attenuate BGC spikes and ultimately decrease postoperative morbidity,without significantly increasing the risk of pulmonary aspiration.The aim of this scoping review is to summarize the available evidence on the impact of PCL on perioperative GV and surgical outcomes,with an emphasis on evidence pertaining to patients with DM.The clinical relevance of GV will be summarized,the relationship between GV and postoperative course will be explored,and the impact of PCL on GV and surgical outcomes will be presented.A total of 13 articles,presented in three sections,were chosen for inclusion.This scoping review concludes that the benefits of a PCL outweigh the risks in most patients,even in those with well controlled type 2 DM.The administration of a PCL might effectively minimize metabolic derangements such as GV and ultimately result in reduced postoperative morbidity and mortality,but this remains to be proven.Future efforts to standardize the content and timing of a PCL are needed.Ultimately,a rigorous data-driven consensus opinion regarding PCL administration that identifies optimal carbohydrate content,volume,and timing of ingestion should be established.展开更多
BACKGROUND Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient’s recovery.Patients with diabetes are prone to delayed gastric emptying.Diffe...BACKGROUND Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient’s recovery.Patients with diabetes are prone to delayed gastric emptying.Different guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation,aspiration and hyperglycemia.Ultrasonic gastric volume(GV)assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes(T2 D)patients.AIM To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2 D patients.METHODS Patients with T2 D receiving surgery under general anesthesia from December 2019 to December 2020 were included.A total of 78 patients were randomly allocated to 4 groups receiving 0,100,200,or 300 m L of carbohydrate loading 2 h before anesthesia induction.Gastric volume per unit weight(GV/W),Perlas grade,changes in blood glucose level,and risk of reflux and aspiration were evaluated before anesthesia induction.RESULTS No significant difference was found in GV/W among the groups before anesthesia induction(P>0.05).The number of patients with Perlas grade II and GV/W>1.5 m L/kg did not differ among the groups(P>0.05).Blood glucose level increased by>2 mmol/L in patients receiving 300 m L carbohydrate drink,which was significantly higher than that in groups 1 and 2(P<0.05).CONCLUSION Preoperative carbohydrate loading<300 m L 2 h before induction of anesthesia in patients with T2 D did not affect GV or increase the risk of reflux and aspiration.Blood glucose levels did not change significantly with preoperative carbohydrate loading of<200 m L.However,300 m L carbohydrate loading may increase blood glucose levels in patients with T2 D before induction of anesthesia.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
Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic r...Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.展开更多
目的:探讨术前预适应训练联合心理干预应用于老年骨质疏松性椎体压缩骨折(Osteoporotic vertebral body compression fractures,OVCF)经皮椎体后凸成形术(Percutaneous vertebral body kyphoplasty,PKP)手术患者的效果。方法:选取2021年...目的:探讨术前预适应训练联合心理干预应用于老年骨质疏松性椎体压缩骨折(Osteoporotic vertebral body compression fractures,OVCF)经皮椎体后凸成形术(Percutaneous vertebral body kyphoplasty,PKP)手术患者的效果。方法:选取2021年8月至2022年8月期间于我院就诊的老年OVCF患者90例,随机分为对照组和观察组,两组各45例。对照组给予常规心理干预,观察组在对照组基础上给予术前预适应训练干预,观察两组术中生命体征变化情况、功能障碍情况及疼痛情况。结果:两组患者心率(Heart rate,HR)、平均动脉压(Mean arterial pressure,MAP)水平均较入室时升高,观察组水平低于对照组(P<0.05);两组患者血氧饱和度(Oxygen saturation of blood,SpO_(2))水平均较入室时降低,观察组水平高于对照组(P<0.05);手术后3d,两组患者Oswestry功能障碍指数(Oswestry dysfunction index,ODI)各维度均较手术前降低,且观察组患者低于对照组(P<0.05);手术后1d,两组患者视觉模拟评分法(Visual analogue scales,VAS)疼痛评分均较手术前降低,且观察组患者低于对照组(P<0.05);两组患者手术后1d椎体高度比较差异无统计学意义。结论:术前预适应训练联合心理干预可以稳定老年OVCF患者PKP术中的生命体征情况,改善术后功能障碍情况,降低疼痛水平,且不会影响手术治疗效果。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
目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按...目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按国内外科学常规进行;糖预处理组及联合治疗组采用术前12h禁食,术前3h口服50%GS 100m L;强化治疗组及联合治疗组术后采用Leuven强化治疗方案治疗。手术当日清晨空腹、术后当天、及术后第1、3、7天空腹采取静脉血标本,监测空腹血糖(FBG),空腹胰岛素定量(FINS),稳态模式评估法(HOMA-2)计算胰岛素抵抗指数,记录术后肠鸣音恢复及首次肛门排气时间,记录并发症。结果联合治疗组与其他三组比较,术后当天、术后第1天、术后第3天的胰岛素抵抗指数明显低于其他三组,差异有统计学意义(P<0.05)。联合治疗组与其他三组比较,肛门排气时间提前,并发症发生率降低,差异有统计学意义(P<0.05)。结论联合术前糖预处理及术后的胰岛素强化治疗处理围手术期患者,较单独应用单一方法更能收到减轻围手术期胰岛素抵抗的目的,且对加快术后排气及减少术后并发症有一定疗效。展开更多
目的:评价术前糖预处理结直肠手术后预防胰岛素抵抗的有效性和安全性,为临床实践提供参考。方法:按照系统评价的要求计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、中国医学会数字化期刊库、PubMed、Coch...目的:评价术前糖预处理结直肠手术后预防胰岛素抵抗的有效性和安全性,为临床实践提供参考。方法:按照系统评价的要求计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、中国医学会数字化期刊库、PubMed、Cochrane Library、EMbase、ISI Web of Knowledge,同时手工检索相关期刊,纳入术前糖预处理结直肠手术后预防胰岛素抵抗的随机对照试验,依据Cochrane评价手册5.0标准对纳入文献的方法学质量进行评估,采用RevMan 5.0软件对符合纳入标准的7个随机对照试验进行Meta分析。结果:共纳入7个随机对照研究,共728例患者。在术前口服碳水化合物组较术前常规禁食水组胰岛素敏感指数(ISI)升高(SMD=-0.38,95%CI=-0.65～0.11,I2=94%)和胰岛素抵抗指数(IRI)降低(SMD=-1.82,95%CI=-2.67～-0.98)方面存在差异,但可降低术前患者饥饿感、焦虑感和口渴感。术前口服碳水化合物较术前口服安慰剂可降低IRI(SMD=-1.34,95%CI=-2.12～-0.57),增加ISI(SMD=1.06,95%CI=0.32～1.81),不能降低术前患者的焦虑感和恶心感。术前口服碳水化合物在术后胰岛素水平(SMD=3.51,95%CI=2.99～4.03)和术后第1天胰岛素水平(SMD=0.65,95%CI=0.31～0.98)方面较术前静滴葡萄糖增高幅度大,且延长患者住院时间(SMD=0.45,95%CI=0.12～0.78)。结论:术前口服碳水化合物较术前常规禁食水更可能降低术前患者饥饿感、焦虑感和口渴感;术前口服碳水化合物较术前口服安慰剂更可能降低IRI和ISI;术前静滴葡萄糖较术前口服碳水化合物更可能增高术后胰岛素敏感程度,且降低患者住院时间。展开更多
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
文摘The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clinical settings.It is now appreciated that acute BGC spikes,hypoglycemia,and high glycemic variability(GV)lead to more endothelial dysfunction and oxidative stress than uncomplicated,chronically elevated BGC.In the perioperative setting,fasting is the primary approach to reducing the risk for pulmonary aspiration;however,prolonged fasting drives the body into a catabolic state and therefore may increase GV.Elevated GV in the perioperative period is associated with an increased risk for postoperative complications,including morbidity and mortality.These challenges pose a conundrum for the management of patients typically instructed to fast for at least 8 h before surgery.Preliminary evidence suggests that the administration of an oral preoperative carbohydrate load(PCL)to stimulate endogenous insulin production and reduce GV in the perioperative period may attenuate BGC spikes and ultimately decrease postoperative morbidity,without significantly increasing the risk of pulmonary aspiration.The aim of this scoping review is to summarize the available evidence on the impact of PCL on perioperative GV and surgical outcomes,with an emphasis on evidence pertaining to patients with DM.The clinical relevance of GV will be summarized,the relationship between GV and postoperative course will be explored,and the impact of PCL on GV and surgical outcomes will be presented.A total of 13 articles,presented in three sections,were chosen for inclusion.This scoping review concludes that the benefits of a PCL outweigh the risks in most patients,even in those with well controlled type 2 DM.The administration of a PCL might effectively minimize metabolic derangements such as GV and ultimately result in reduced postoperative morbidity and mortality,but this remains to be proven.Future efforts to standardize the content and timing of a PCL are needed.Ultimately,a rigorous data-driven consensus opinion regarding PCL administration that identifies optimal carbohydrate content,volume,and timing of ingestion should be established.
基金Supported by Natural Science Foundation of Fujian Province,No.2019J01587。
文摘BACKGROUND Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient’s recovery.Patients with diabetes are prone to delayed gastric emptying.Different guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation,aspiration and hyperglycemia.Ultrasonic gastric volume(GV)assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes(T2 D)patients.AIM To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2 D patients.METHODS Patients with T2 D receiving surgery under general anesthesia from December 2019 to December 2020 were included.A total of 78 patients were randomly allocated to 4 groups receiving 0,100,200,or 300 m L of carbohydrate loading 2 h before anesthesia induction.Gastric volume per unit weight(GV/W),Perlas grade,changes in blood glucose level,and risk of reflux and aspiration were evaluated before anesthesia induction.RESULTS No significant difference was found in GV/W among the groups before anesthesia induction(P>0.05).The number of patients with Perlas grade II and GV/W>1.5 m L/kg did not differ among the groups(P>0.05).Blood glucose level increased by>2 mmol/L in patients receiving 300 m L carbohydrate drink,which was significantly higher than that in groups 1 and 2(P<0.05).CONCLUSION Preoperative carbohydrate loading<300 m L 2 h before induction of anesthesia in patients with T2 D did not affect GV or increase the risk of reflux and aspiration.Blood glucose levels did not change significantly with preoperative carbohydrate loading of<200 m L.However,300 m L carbohydrate loading may increase blood glucose levels in patients with T2 D before induction of anesthesia.
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Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.
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。
文摘目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按国内外科学常规进行;糖预处理组及联合治疗组采用术前12h禁食,术前3h口服50%GS 100m L;强化治疗组及联合治疗组术后采用Leuven强化治疗方案治疗。手术当日清晨空腹、术后当天、及术后第1、3、7天空腹采取静脉血标本,监测空腹血糖(FBG),空腹胰岛素定量(FINS),稳态模式评估法(HOMA-2)计算胰岛素抵抗指数,记录术后肠鸣音恢复及首次肛门排气时间,记录并发症。结果联合治疗组与其他三组比较,术后当天、术后第1天、术后第3天的胰岛素抵抗指数明显低于其他三组,差异有统计学意义(P<0.05)。联合治疗组与其他三组比较,肛门排气时间提前,并发症发生率降低,差异有统计学意义(P<0.05)。结论联合术前糖预处理及术后的胰岛素强化治疗处理围手术期患者,较单独应用单一方法更能收到减轻围手术期胰岛素抵抗的目的,且对加快术后排气及减少术后并发症有一定疗效。
文摘目的:评价术前糖预处理结直肠手术后预防胰岛素抵抗的有效性和安全性,为临床实践提供参考。方法:按照系统评价的要求计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、中国医学会数字化期刊库、PubMed、Cochrane Library、EMbase、ISI Web of Knowledge,同时手工检索相关期刊,纳入术前糖预处理结直肠手术后预防胰岛素抵抗的随机对照试验,依据Cochrane评价手册5.0标准对纳入文献的方法学质量进行评估,采用RevMan 5.0软件对符合纳入标准的7个随机对照试验进行Meta分析。结果:共纳入7个随机对照研究,共728例患者。在术前口服碳水化合物组较术前常规禁食水组胰岛素敏感指数(ISI)升高(SMD=-0.38,95%CI=-0.65～0.11,I2=94%)和胰岛素抵抗指数(IRI)降低(SMD=-1.82,95%CI=-2.67～-0.98)方面存在差异,但可降低术前患者饥饿感、焦虑感和口渴感。术前口服碳水化合物较术前口服安慰剂可降低IRI(SMD=-1.34,95%CI=-2.12～-0.57),增加ISI(SMD=1.06,95%CI=0.32～1.81),不能降低术前患者的焦虑感和恶心感。术前口服碳水化合物在术后胰岛素水平(SMD=3.51,95%CI=2.99～4.03)和术后第1天胰岛素水平(SMD=0.65,95%CI=0.31～0.98)方面较术前静滴葡萄糖增高幅度大,且延长患者住院时间(SMD=0.45,95%CI=0.12～0.78)。结论:术前口服碳水化合物较术前常规禁食水更可能降低术前患者饥饿感、焦虑感和口渴感;术前口服碳水化合物较术前口服安慰剂更可能降低IRI和ISI;术前静滴葡萄糖较术前口服碳水化合物更可能增高术后胰岛素敏感程度,且降低患者住院时间。
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。
