中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2013年
6期
1303-1304
,共2页
乌司他丁%食管癌术后%应激性高血糖
烏司他丁%食管癌術後%應激性高血糖
오사타정%식관암술후%응격성고혈당
Ulinastatin%Esophageal cancer after thoracotomy%Stress hyperglycemia
目的 观察乌司他丁(UTI)对食管癌手术后患者应激性高血糖的影响.方法 60例食管癌手术后确诊合并应激性高血糖的患者随机分为2组,其中对照组(C组,n=30)接受常规胰岛素降血糖治疗及其他综合治疗,联用UTI组(UTI组,n=30)在对照组治疗方法的基础上加用UTI.术后第1、3、5天检测空腹血糖(BG)、空腹胰岛素(INS)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)的水平,计算胰岛素敏感指数(ISI).结果 两组术后第1天各项指标差异无统计学意义(P＞0.05).UTI组第3天TNF-α(48.27±13.92) μg/L、IL-6(172.38±19.82) μg/L、BG(7.48±1.72) mmol/L、INS(11.32 ±3.47) mU/L水平已呈下降趋势,ISI (-4.37 ±0.35)渐升高(P＜0.05),第5天TNF-α(32.10±15.64) μg/L、IL-6(113.83 ±21.33) μg/L、BG(5.61±1.57) mmol/L、INS(8.48±3.63) mU/L、ISI-(3.80±0.29)已恢复(P＜0.05).C组相应指标各阶段恢复均慢于UTI组(P＜0.05).且UTI组感染率(6.67％,2/30)较C组(30.00％,9/30)降低(P＜0.05).结论 联用UTI能较单用胰岛素更有效地控制食管癌手术后应激性高血糖.
目的 觀察烏司他丁(UTI)對食管癌手術後患者應激性高血糖的影響.方法 60例食管癌手術後確診閤併應激性高血糖的患者隨機分為2組,其中對照組(C組,n=30)接受常規胰島素降血糖治療及其他綜閤治療,聯用UTI組(UTI組,n=30)在對照組治療方法的基礎上加用UTI.術後第1、3、5天檢測空腹血糖(BG)、空腹胰島素(INS)、腫瘤壞死因子-α(TNF-α)以及白細胞介素-6(IL-6)的水平,計算胰島素敏感指數(ISI).結果 兩組術後第1天各項指標差異無統計學意義(P＞0.05).UTI組第3天TNF-α(48.27±13.92) μg/L、IL-6(172.38±19.82) μg/L、BG(7.48±1.72) mmol/L、INS(11.32 ±3.47) mU/L水平已呈下降趨勢,ISI (-4.37 ±0.35)漸升高(P＜0.05),第5天TNF-α(32.10±15.64) μg/L、IL-6(113.83 ±21.33) μg/L、BG(5.61±1.57) mmol/L、INS(8.48±3.63) mU/L、ISI-(3.80±0.29)已恢複(P＜0.05).C組相應指標各階段恢複均慢于UTI組(P＜0.05).且UTI組感染率(6.67％,2/30)較C組(30.00％,9/30)降低(P＜0.05).結論 聯用UTI能較單用胰島素更有效地控製食管癌手術後應激性高血糖.
목적 관찰오사타정(UTI)대식관암수술후환자응격성고혈당적영향.방법 60례식관암수술후학진합병응격성고혈당적환자수궤분위2조,기중대조조(C조,n=30)접수상규이도소강혈당치료급기타종합치료,련용UTI조(UTI조,n=30)재대조조치료방법적기출상가용UTI.술후제1、3、5천검측공복혈당(BG)、공복이도소(INS)、종류배사인자-α(TNF-α)이급백세포개소-6(IL-6)적수평,계산이도소민감지수(ISI).결과 량조술후제1천각항지표차이무통계학의의(P＞0.05).UTI조제3천TNF-α(48.27±13.92) μg/L、IL-6(172.38±19.82) μg/L、BG(7.48±1.72) mmol/L、INS(11.32 ±3.47) mU/L수평이정하강추세,ISI (-4.37 ±0.35)점승고(P＜0.05),제5천TNF-α(32.10±15.64) μg/L、IL-6(113.83 ±21.33) μg/L、BG(5.61±1.57) mmol/L、INS(8.48±3.63) mU/L、ISI-(3.80±0.29)이회복(P＜0.05).C조상응지표각계단회복균만우UTI조(P＜0.05).차UTI조감염솔(6.67％,2/30)교C조(30.00％,9/30)강저(P＜0.05).결론 련용UTI능교단용이도소경유효지공제식관암수술후응격성고혈당.
Objective To evaluate the effect of ulinastatin (UTI) on stress hyperglycemia in patients with esophageal cancer after thoracotomy.Methods Sixty patients who suffered from esophageal cancer and were diagnosed of combined stress hyperglycemia after thoracotomy were divided into two groups randomly.Both control group (group C,n =30) and UTI treatment group (group UTI,n =30) were given regular treatment with insulin and other comprehensive treatment.Group UTI was given UTI additionally.The morning fasting blood glucose (BG),fasting insulin (INS),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels and insulin sensitivity index (ISI) were measured at postoperative day (POD) 1,3,and 5.Results At POD 1,the indexes had no significant difference between two groups (P ＞ 0.05).At POD 3,the level of TNF-α (48.27 ± 13.92) μg/L,IL-6 (172.38 ± 19.82) μg/L,BG (7.48 ± 1.72)mmol/L,and INS (11.32 ± 3.47) mU/L in group UTI was decreased,and ISI (-4.37 ± 0.35) was gradually increased as compared with group C (P ＜ 0.05).The level of TNF-α (32.10 ± 15.64) μg/L,IL-6 (113.83 ±21.33) μg/L,BG (5.61 ± 1.57) mmol/L,INS (8.48 ±3.63) mU/L and ISI-(3.80 ±0.29) in group UTI recoverd obviously at POD 5 (P ＜ 0.05).At each phase of group C,recovery of corresponding indexes was slower than in group UTI (P ＜0.05).Besides,infection rate was lower in group UTI (6.67％,2/30) than in group C (30.00％,9/30) (P ＜ 0.05).Conclusion The combined use of UTI with insulin can more effectively control the stress hyperglycemia after esophageal thoracotomy than insulin used alone.
