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Oral Glucose Combined with Short-Term Intravenous Nutrition for the Prevention of Hypoglycemia after Painless Endoscopic Gastric Polypectomy

DOI: 10.4236/ym.2023.73018, PP. 177-184

Keywords: Gastric Polyps, Endoscopic Polyp Resection, Anesthesia, Intravenous Nutrition, Glucose, Hypoglycemia

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Abstract:

Objective: To explore the application effect of oral glucose combined with short-term intravenous nutrition in preventing postoperative hypoglycemia after painless endoscopic gastric polyp resection, and to provide guidance for better management of patients undergoing such procedures. Methods: A total of 886 patients who underwent painless endoscopic gastric polyp resection in the Department of Gastroenterology, the First Affiliated Hospital of Yangtze University, from January 2020 to December 2021, were selected as the study subjects. According to the random number table method, they were divided into an experimental group and a control group, with 443 cases in each group. Patients in the control group were subjected to routine fasting and water restriction for 8 hours before surgery, and routine fasting for 24 hours after surgery. Short-term intravenous nutrition support was provided through fluid supplementation, and finger blood glucose levels were monitored at 1 hour, 4 hours, and 8 hours after completion of intravenous infusion, or when symptoms such as palpitations and cold sweats occurred. The experimental group received oral administration of 5% glucose solution (500 ml) 2 hours before surgery based on the procedures of the control group. The incidence of preoperative discomfort (hunger, thirst, and fatigue), residual gastric fluid volume, and postoperative hypoglycemia were compared between the two groups. Results: The incidence of postoperative blood glucose < 3.9 mmol/L and hypoglycemia in the experimental group was significantly lower than that in the control group (4.29% vs. 8.80%, P = 0.007; 6.09% vs. 12.42%, P = 0.001). There were no significant differences between the experimental and control groups in terms of residual gastric fluid volume and incidence of reflux aspiration (26.36 ± 3.41 ml vs. 24.83 ± 4.66 ml, P = 0.86; 0.45% vs. 0.68%, P = 0.654). Conclusion: Based on the study population, oral glucose combined with short-term intravenous nutrition can effectively prevent the incidence of hypoglycemia in patients undergoing painless endoscopic gastric polyp resection. However, due to the limitations of a single-center study and a small number of cases, its feasibility needs to be further validated with more data from multi-center and large-sample cases.

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