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目的:评价术前口服糖类溶液对择期结肠癌病人术后即时胰岛素抵抗的影响。方法:随机将择期结肠癌手术病人32例分为两组,对照组术前常规禁食禁水,试验组在术前3h给予糖类溶液口服。分别在手术前1天15:00和手术当天早晨服药后2h用视觉模拟评分法(VAS)测定两组病人的主观舒适度;在术前4h及术后即刻抽取外周血测定血清葡萄糖和胰岛素浓度,并用稳态模式评估法(HOMA)计算胰岛素抵抗指数、胰岛素分泌指数和胰岛素敏感指数等。结果:术前口服糖类溶液,可明显减轻术前1h的口渴感、饥饿感和焦虑感。对照组术后胰岛素敏感指数下降了38%,而试验组下降了33%(P<0.01)。试验组的胰岛素抵抗程度较对照组改善37%。结论:术前口服糖类溶液安全有效,可改善病人术后即时胰岛素抵抗。
Objective: To evaluate the effect of preoperative oral carbohydrate solution on postoperative immediate insulin resistance in patients with elective colon cancer. Methods: Thirty-two cases of elective colon cancer surgery were randomly divided into two groups. The control group was given conventional fasting water forbidden. The experimental group was orally administered with saccharide solution 3h before operation. The subjective comfort of the two groups was measured by visual analogue scale (VAS) at 15:00 one day before operation and 2 hours after the morning operation on the day of surgery. Serum glucose and insulin concentrations were measured at 4h and immediately after operation , And insulin resistance index, insulin secretion index and insulin sensitivity index were calculated by steady-state model assessment (HOMA). Results: Preoperative oral glucose solution can significantly reduce thirst, hunger and anxiety 1h before surgery. In the control group, the postoperative insulin sensitivity index decreased by 38%, while the experimental group decreased by 33% (P <0.01). Insulin resistance in the experimental group improved 37% compared with the control group. Conclusion: Preoperative oral saccharide solution is safe and effective, which can improve immediate postoperative insulin resistance.