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目的探讨腹腔镜肾根治性切除术(LRN)对胰岛素抵抗的影响。方法肾癌根治术肾癌患者72例分为LRN组(34例)和开放肾根治性切除术组(ORN组,38例)。于术前及手术结束后抽取静脉血检测血清胰岛素(FINS)、空腹血糖(FBG),计算胰岛素抵抗指数(IRI)、胰岛分泌指数(HOMAβ)、胰岛素敏感指数(ISI)。分析手术对胰岛素抵抗的影响。结果两组患者术后FBG、FINS和IRI均明显高于术前水平(P<0.05),ISI显著低于术前(P<0.05)。术后ORN组的FBG、FINS和IRI明显高于LRN组(P<0.05),ORN组患者术后ISI明显低于LRN组(P<0.05)。结论与ORN手术相比,LRN手术对术后胰岛素抵抗的影响较小。
Objective To investigate the effect of laparoscopic radical nephrectomy (LRN) on insulin resistance. Methods 72 patients with renal cell carcinoma who underwent radical mastectomy were divided into three groups: LRN group (34 cases) and open radical nephrectomy group (ORN group, 38 cases). Venous blood samples were collected before surgery and after operation. Serum insulin (FINS), fasting blood glucose (FBG), insulin resistance index (IRI), insulin secretion index (HOMAβ) and insulin sensitivity index (ISI) were measured. Analysis of the impact of surgery on insulin resistance. Results The postoperative FBG, FINS and IRI of the two groups were significantly higher than those before operation (P <0.05), and the ISI was significantly lower than that before operation (P <0.05). The postoperative FBG, FINS and IRI in ORN group were significantly higher than those in LRN group (P <0.05). The ISI in ORN group was significantly lower than that in LRN group (P <0.05). Conclusion Compared with ORN surgery, LRN surgery has little effect on postoperative insulin resistance.