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目的:研究胃癌患者术前口服碳水化合物的安全性及对术后胰岛素抵抗影响。方法:选取胃下部癌病理诊断明确的患者32例,取得知情同意后按照随机双盲的试验,参与者麻醉前2-3小时口服碳水化合物或安慰剂,术前4小时及术后即刻抽取静脉血测定血糖、胰岛素及C-反应蛋白浓度,通过HOMA发计算出术前术后胰岛素抵抗指数、胰岛素敏感指数、胰岛素分泌指数,并将两组进行比较。结果:与口服安慰剂组相比较,术前口服碳水化合物组的血糖、胰岛素、C-反应蛋白及胰岛素抵抗指数更低,且两组患者术后胰岛素敏感性均下降,但口服碳水化合物组的胰岛素敏感性较安慰剂组高。结论:术前2-3小时口服碳水化合物是安全有效的,且能明显术后即刻胰岛素抵抗状态,应作为术前常规处理。
Objective: To study the safety of preoperative oral carbohydrate in gastric cancer patients and its effect on postoperative insulin resistance. Methods: Thirty-two patients with pathologically diagnosed gastric cancer were enrolled in the study. Randomized, double-blind trials were conducted with informed consent. Participants received oral carbohydrates or placebo 2-3 hours prior to anesthesia. Venous immediately after 4 hours and immediately after surgery Blood glucose, insulin and C-reactive protein concentrations were measured. Preoperative and postoperative insulin resistance index, insulin sensitivity index and insulin secretion index were calculated by HOMA. The two groups were compared. Results: Compared with the oral placebo group, preoperative oral carbohydrate group had lower blood glucose, insulin, C-reactive protein and insulin resistance index, and insulin sensitivity decreased in both groups after oral administration of carbohydrate group Insulin sensitivity than placebo group. CONCLUSIONS: Carbohydrates administered orally 2-3 hours prior to surgery are safe and effective, and have an immediate postoperative immediate insulin resistance status. They should be routinely administered preoperatively.