摘要
目的探讨糖预处理对胃肠道肿瘤手术后胰岛素抵抗的影响。方法选取60例择期行胃肠道肿瘤手术患者，按随机数字表法分为观察组和对照组，每组30例。观察组术前给予糖预处理，即麻醉前2h口服含50g葡萄糖的碳水化合物300ml；对照组患者按传统方法进行处理，术前12h禁食，术前6h禁饮。于术前3h和术后1，3，7d分别抽取患者外周血，监测空腹血糖（FBG）、空腹胰岛素（FINS）水平，采用稳态模型法计算胰岛素抵抗指数（HOMA．IR）。结果术后1，3d两组FBG、FINS水平及HOMA．IR均明显高于术前3h[观察组：（10．65±1．78）、（7．32±1．48）mmol／L比（5．09±0．43）mmol／L，（25．78±12．43）、（16．23±7．56）mU／L比（10．48±1．57）mU／L，11．67±6．32、5．12±2．11比2．35±0．54；对照组：（11．18±1．25）、（8．04±1．53）mmol／L比（5．12±0．39）mmol／L，（39．67±10．37）、（24．34±6．78）mU／L比（9．98±2．04）mU／L，19．07±5．49、8．56±2．87比2．28±0．39]，差异有统计学意义（P〈0．05）；术后1d对照组FINS及HOMA-IR明显高于观察组，术后3d对照组FINS及HOMA-IR明显高于观察组，差异有统计学意义（P〈0．05）；术后7d观察组FINS及HOMA．IR接近术前3h，差异无统计学意义（P〉0．05），而对照组[（16．32±4．56）mU／L、3．87±1．123仍高于术前3h，差异有统计学意义（P〈0．05）。结论糖预处理可以缩短胃肠道肿瘤手术后胰岛素抵抗的时间，减轻胰岛素抵抗的强度，从而有利于患者的加速康复。
Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection. Methods Sixty elective gastroenterie tumor resection patients were divided into observation group and control group by random number table method, with 30 cases in each. Observation group was given carbohydrate administration before surgery, that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose; control group was treated according to the traditional methods, preoperative fasting 12 h, 6 h forbidden to drink. The blood samples were collected to measure the levels of fasting blood glucose （FBG） and fasting insuhn （FINS） at 3 h before operation and 1,3,7 d postoperation respectively. Homeostasis modal assessment （HOMA） was applied to calculate the insulin resistance index. Results The levels of FBG,FINS, HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [ observation group： （ 10.65 ± 1.78）, （7.32 ± 1.48 ） mmol/L vs. （5.09 ±0.43） mmol/L, （25.78 ± 12.43）, （16.23 ±7.56） mU/L vs. （10.48 ± 1.57） mU/L,11.67 ±6.32, 5.12 ± 2.11 vs. 2.35 ± 0.54;eontrol group. （ 11.18 ± 1.25 ）, （8.04 ± 1.53） mmol/L vs.（5.12 ± 0.39） mmol/L, （39.67 ± 10.37 ）, （24.34 ± 6.78） mU/L vs. （9.98 ± 2.04） mU/L, 19.07 ± 5.49,8.56 ± 2.87 vs. 2.28 ± 0.39 ] （P 〈 0.05 ）. The levels of FINS, HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group （P 〈 0.05）. The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative （P 〉 0.05 ）, while the levels in control group [ （ 16.32 ± 4.56） mU/L, 3.87 ± 1.12] was still higher than those at 3 h preoperation （P 〈 0.05）. Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection, and reduce the intensity of insulin resistance, thus contributing to the rehabilitation of patients.
出处
《中国医师进修杂志》
2014年第20期8-10,共3页
Chinese Journal of Postgraduates of Medicine
基金
中国石油华北油田临床医学研究项目（2013-HG-G-19-1）
关键词
胃肠道间质肿瘤
胰岛素抗药性
糖预处理
Gastroentestinal stromal tumors
Insulin resistance
Preoperative carbohydrate administration
