不同麻醉方法对上腹部围手术期血糖和胰岛素的影响  

THE EFFECT OF DIFFERENT ANESTHESIA METHODS ON THE CONCENTRATION OF GLUCOSE AND INSULIN AT PERIOPERATION PERIOD

作　　者：施培青 张晓萍[1] 邱谷[1] 马正美[1] 江恬[1] 

机构地区：[1]江苏省南通市第二人民医院,南通226002

出　　处：《南通医学院学报》2001年第3期250-251,共2页ACTA Academiae Medicinae Nantong

摘　　要：目的 :探讨三种不同麻醉方法对围手术期血糖浓度和胰岛素的影响。方法 :30例择期上腹部手术随机分为 3组 :静脉复合全麻组 ( 组 ) ,静脉吸入复合全麻组 ( 组 )、静脉全麻复合硬膜外阻滞 ( 组 )。测定麻醉前 (t0 )、手术开始后 6 0分钟 (t1 )、术后 1天 (t2 )、术后 2天 (t3)、术后 3天 (t4)血中血糖 (GL U )浓度和胰岛素 (INS)值。结果 :3组患者术中 GL U、INS比麻醉前升高 (P<0 .0 1)。 、 组患者 GL U、INS术后 72小时处高值位置 ,INS 组术后 3天是麻醉前的 3.6 2倍。 组患者 GL U、INS各个时相与麻醉前相比变化幅度小 ,术后 3天基本恢复 ,达麻醉前水平或更低。 组 GL U浓度和 INS值变化明显小于 组 (P<0 .0 1)。结论 :静脉全麻复合硬膜外阻滞麻醉方法用于上腹部手术 ,对血中 GL U浓度和 INS值变化影响最小 ,控制术中应激反应效果显著 ,机体恢复较快 。Objective:To investigate the effect of three different anesthesia methods applied to upper abdominal surgeries on the concentrations of glucose(GLU) and insulin(INS) at perioperation period.Methods:Thirty cases of upper abdominal surgeries were randomly divided into three groups:intravenous balanced general anesthesia(groupⅠ),intravenous inhalation blanced general anesthesia(groupⅡ),intravenous general anesthesia balanced epidural block(groupⅢ).The concentrations of GLU and INS were measured at five different time which is before anesthesia induction(t 0),60 minutes after operation(t 1),1 days after operation(t 2),2 days after operation(t 3) and 3 days after operation(t 4).Results:Of all the three groups the concentrations of GLU and INS increased after operation compared with before anesthesia induction (P<0.01).In both group Ⅰ and the concentrations of GLU and INS remained high at 3 days after operation,and in group Ⅱ the concentrations of INS at 3 days after operation was as 3.62 times high as tha before anesthesia induction,but in group Ⅲ the concentrations of GLU and INS didn't change much after operation and nearly returned to the level of before anesthesia induction or lower at 3 days after operation.The concentratons of GLU and INS in grup Ⅰ changed more obviously than those in group Ⅲ(P<0.01).Conclusion:Among the three different methods,intravenous general anesthesia balanced epidural block is better than other two methods,because it has least effect on the concentrations of GLU and INS and its capability of controlling reaction to stimulation enables patients to recover soon.

关 键 词：上腹部手术 麻醉方法 围手术期 血糖 胰岛素 

分 类 号：R656[医药卫生—外科学] R614.1[医药卫生—临床医学]