中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2010年
3期
149-152
,共4页
安琦%朱明炜%崔红元%唐普贤%唐大年%周新平%韦军民
安琦%硃明煒%崔紅元%唐普賢%唐大年%週新平%韋軍民
안기%주명위%최홍원%당보현%당대년%주신평%위군민
果糖%木糖醇%老年人%腹部手术%血糖%胰岛功能
果糖%木糖醇%老年人%腹部手術%血糖%胰島功能
과당%목당순%노년인%복부수술%혈당%이도공능
Fructose%Xylitol%Elderly patient%Abdominal operation%Serum glucose%Pancreas islet function
目的 评价混合糖对腹部手术后老年患者血糖、胰岛功能以及安全性的影响.方法 采用前瞻、随机、双盲、对照的研究方法.满足方案入选标准并获得知情同意的腹部手术后老年患者共40例进入本研究.研究组于术后第1天或第2天开始连续静脉输注混合糖电解质注射液1 000 ml,对照组静脉输注10%葡萄糖电解质注射液1000ml,连续3 d.观察血糖和胰岛素、胰岛素C肽的变化,同时观察临床结局指标和血尿酸、乳酸等的变化以及不良事件.结果 按计划完成本研究40例,无淘汰病例;腹部手术后老年患者输注混合糖后第2和3天血糖升高幅度明显少于对照组(P=0.008,P=0.001);血胰岛素和胰岛素C肽水平两组较术前均有升高趋势,但组间比较差异无统计学意义;研究组的变化值分别为(11.4±7.8)μU/ml和(639±506)pmol/L,对照组的变化值分别为(13.9±13.0)μU/ml和(1 062±905)pmol/L,两组比较差异无统计学意义(P=0.612,P=0.213).研究组术后发生全身性炎症反应综合征(6例)和感染并发症(4例)的病例数与对照组(8和6例)比较差异无统计学意义(P=0.639,P=0.606);用药后两组患者均未发现血乳酸和尿酸升高,未出现不良事件.结论 适量应用混合糖对腹部手术后患者血糖和胰岛功能的影响较小,可能改善临床结局.
目的 評價混閤糖對腹部手術後老年患者血糖、胰島功能以及安全性的影響.方法 採用前瞻、隨機、雙盲、對照的研究方法.滿足方案入選標準併穫得知情同意的腹部手術後老年患者共40例進入本研究.研究組于術後第1天或第2天開始連續靜脈輸註混閤糖電解質註射液1 000 ml,對照組靜脈輸註10%葡萄糖電解質註射液1000ml,連續3 d.觀察血糖和胰島素、胰島素C肽的變化,同時觀察臨床結跼指標和血尿痠、乳痠等的變化以及不良事件.結果 按計劃完成本研究40例,無淘汰病例;腹部手術後老年患者輸註混閤糖後第2和3天血糖升高幅度明顯少于對照組(P=0.008,P=0.001);血胰島素和胰島素C肽水平兩組較術前均有升高趨勢,但組間比較差異無統計學意義;研究組的變化值分彆為(11.4±7.8)μU/ml和(639±506)pmol/L,對照組的變化值分彆為(13.9±13.0)μU/ml和(1 062±905)pmol/L,兩組比較差異無統計學意義(P=0.612,P=0.213).研究組術後髮生全身性炎癥反應綜閤徵(6例)和感染併髮癥(4例)的病例數與對照組(8和6例)比較差異無統計學意義(P=0.639,P=0.606);用藥後兩組患者均未髮現血乳痠和尿痠升高,未齣現不良事件.結論 適量應用混閤糖對腹部手術後患者血糖和胰島功能的影響較小,可能改善臨床結跼.
목적 평개혼합당대복부수술후노년환자혈당、이도공능이급안전성적영향.방법 채용전첨、수궤、쌍맹、대조적연구방법.만족방안입선표준병획득지정동의적복부수술후노년환자공40례진입본연구.연구조우술후제1천혹제2천개시련속정맥수주혼합당전해질주사액1 000 ml,대조조정맥수주10%포도당전해질주사액1000ml,련속3 d.관찰혈당화이도소、이도소C태적변화,동시관찰림상결국지표화혈뇨산、유산등적변화이급불량사건.결과 안계화완성본연구40례,무도태병례;복부수술후노년환자수주혼합당후제2화3천혈당승고폭도명현소우대조조(P=0.008,P=0.001);혈이도소화이도소C태수평량조교술전균유승고추세,단조간비교차이무통계학의의;연구조적변화치분별위(11.4±7.8)μU/ml화(639±506)pmol/L,대조조적변화치분별위(13.9±13.0)μU/ml화(1 062±905)pmol/L,량조비교차이무통계학의의(P=0.612,P=0.213).연구조술후발생전신성염증반응종합정(6례)화감염병발증(4례)적병례수여대조조(8화6례)비교차이무통계학의의(P=0.639,P=0.606);용약후량조환자균미발현혈유산화뇨산승고,미출현불량사건.결론 괄량응용혼합당대복부수술후환자혈당화이도공능적영향교소,가능개선림상결국.
Objective To evaluate the effects of carbohydrate-electrolyte solution(CES)on serum glucose,pancreas islet function,and safety in elderly patients after abdominal operation.Methods In this prospective,double-blinded,randomized,and controlled study,40 elderly patients who met the defined criteria were enrolled.Subjects in CES group were intravenously administered with 1 000 ml CES for consecutive three days beginning from the 1st and 2nd post-operative day,while subjects in the control group were administered with 10% glucose of the same volume under the same arrangement.The changes of serum glucose,insulin and insulin C-peptide,as well as lactic acid and uric acid and uric acid were determined before and after injection.Adverse events were recorded.Results All patients completed the study.The increase rate of serum glucose was significantly lower on the 2nd and 3rd day after injection in CES group than in control group(P=0.008,P:0.001).Blood insulin and insulin C-peptide levels showed increasing trends in both two groups,but were not significantly different between two groups(P=0.612,P=0.213).In the CES group,6 patients experienced systemic inflammatory response syndrome and 4 patients had infective complications after surgeries ;on the contrary,these two numerals were 8 and 6 in the control group(P=0.639,P=0.606).No increase in serum lactic acid or uric acid was detected.Conclusion Appropriate application of CES has minimal effect on the blood gluocse and pancreas islet function in elderly patients after abdominal surgery and may be helpful to improve clinical outcomes.
