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目的探讨不同术前禁食时间对结肠癌根治性切除术后胰岛素抵抗的影响。方法回顾性分析77例结直肠癌根治性切除术患者,将手术患者分为术前禁食时间>12 h(A组)、8 h~12 h(B组)、4 h~8 h(C组)3个组。分析各组围手术期(术前、术后第1 d、术后第3 d和术后第7 d)的空腹血糖、胰岛素浓度,并计算各组胰岛素抵抗指数,评价患者的胰岛素抵抗情况。结果在结肠癌根治性切除术后第1 d和第3 d,B组和C组患者空腹血糖浓度、胰岛素浓度、胰岛素抵抗指数明显低于A组,差异有统计学意义(P<0.01);而在术后第7 d,这些指标3组间差异无统计学意义。结论延长术前禁食时间可增加术后胰岛素抵抗程度,术前禁食>12 h可增加术后胰岛素抵抗的风险。
Objective To investigate the effect of different preoperative fasting time on insulin resistance after radical resection of colon cancer. Methods A total of 77 patients with radical resection of colorectal cancer were retrospectively analyzed. The patients were divided into three groups: preoperative fasting time> 12 h (group A), 8 h to 12 h (group B), 4 h to 8 h Group) 3 groups. Fasting blood glucose and insulin concentration were measured during perioperative period (preoperative, postoperative 1st day, 3rd day and postoperative day 7), and insulin resistance index of each group was calculated to evaluate the patients’ insulin resistance. Results The fasting blood glucose, insulin and insulin resistance index of group B and group C were significantly lower than those of group A on the first day and the third day after radical resection of colon cancer (P <0.01). On the 7th day after operation, there was no significant difference among these 3 groups. Conclusion Prolonged preoperative fasting time can increase the degree of postoperative insulin resistance. Preoperative fasting> 12 h can increase the risk of postoperative insulin resistance.