CAJ | 학술논문

目的观察术前口服葡萄糖溶液对胃肠手术后血糖、胰岛素抵抗(insulin resistance,IR)及炎症反应的影响.方法 48例胃肠手术采用区组随机法随机分为研究组23例及对照组25例.研究组术前3h前口服25％葡萄糖溶液300 ml,比较2组术前胃内容物量、pH值及术后第1天的血清高敏C反应蛋白(high sensitivity C-reactive protein,hsCRP)、空腹血糖、胰岛素水平、胰岛素抵抗指数稳态模型(homeostasis model assessment-insulin resistance,HOMA-IR).结果 2组均无麻醉及手术并发症.麻醉前2组胃内容物量、pH值差异无统计学意义;术前2组hsCRP、血糖、胰岛素水平、HOMA-IR差异无统计学意义.术后第1天研究组空腹血糖、HOMA-IR及hsCRP均明显低于对照组(6.51±1.15 vs 7.49±0.57 mmol/L,P =0.038),(4.34±1.60 vs 6.09 ±2.81,P =0.043),(40.45±27.02 vs 80.02±38.98 mg/L,P =0.03),差异有统计学意义.结论术前口服葡萄糖溶液可明显改善患者术后血糖及IR,减轻术后炎症反应.
목적 관찰술전구복포도당용액대위장수술후혈당、이도소저항(insulin resistance,IR)급염증반응적영향.방법 48례위장수술채용구조수궤법수궤분위연구조23례급대조조25례.연구조술전3h전구복25％포도당용액300 ml,비교2조술전위내용물량、pH치급술후제1천적혈청고민C반응단백(high sensitivity C-reactive protein,hsCRP)、공복혈당、이도소수평、이도소저항지수은태모형(homeostasis model assessment-insulin resistance,HOMA-IR).결과 2조균무마취급수술병발증.마취전2조위내용물량、pH치차이무통계학의의;술전2조hsCRP、혈당、이도소수평、HOMA-IR차이무통계학의의.술후제1천연구조공복혈당、HOMA-IR급hsCRP균명현저우대조조(6.51±1.15 vs 7.49±0.57 mmol/L,P =0.038),(4.34±1.60 vs 6.09 ±2.81,P =0.043),(40.45±27.02 vs 80.02±38.98 mg/L,P =0.03),차이유통계학의의.결론 술전구복포도당용액가명현개선환자술후혈당급IR,감경술후염증반응.
Objective To observe the effect of preoperative oral administration of carbohydrate on blood glucose,insulin resistance(IR) and inflammatory reaction after gastrointestinal operation.Methods 48 patients receiving gastrointestinal operation were randomly divided into the study group(n =23)and the control group(n =25).Patients in the study group were orally given 25％ glucose solution 300 ml 3 hours before operation.Before anesthesia induction,gastric contents were aspirated through nasogastric tube to examine its volume and pH.Serum high sensitivity C-reactive protein(hsCRP),fasting blood glucose,insulin level and homeostasis model assessment-insulin resistance(HOMA-IR) were detected before operation and on the first morning after operation between the two groups.Results No anesthesia or operation related complications occurred in either groups.Patients had similar gastric contents volume and the PH value of gastric contents.There was no significant difference in serum hsCRP,fasting blood glucose and HOMA-IR between the two groups before operation.But on the first day,fasting blood glucose,HOMA-IR and hsCRP were significantly lower in the study group than in the control group(6.51 ±1.15 vs 7.49 ±0.57 mmol/L,P =0.038;4.34 ± 1.60 vs 6.09 ±2.81,P =0.043;40.45 ± 27.02 vs 80.02 ± 38.98 mg/L,P =0.03).Conclusion Preoperative oral administration of carbohydrate can obviously lower the postoperative blood glucose level and insulin resistance and alleviate postoperative inflammatory reaction.