肝癌合并糖尿病患者术前禁食、水方案研究  

Preoperative Fasting for Solids and Liquids Program for Liver Cancer Patients Combined with Diabetes

作　　者：陆丽华[1] 陈萃[1] 纪丹妮[1] 李正俊 年桂红[1] 倪春燕[2] 王葵[1] 叶志霞[3] 

机构地区：[1]第二军医大学东方肝胆外科医院肝外四科,上海200438 [2]第二军医大学东方肝胆外科医院肝外三科 [3]第二军医大学东方肝胆外科医院护理部

出　　处：《解放军护理杂志》2015年第3期6-9,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：第二军医大学青年启动基金资助项目(2011QN21)

摘　　要：目的探讨适合肝癌合并糖尿病患者的术前禁食、水方案。方法 2011年8月至2013年7月,便利抽样法选取在第二军医大学东方肝胆外科医院治疗的肝癌合并糖尿病患者120例为研究对象,按其入院时间的先后将其分为观察组和对照组,每组60例。观察组患者术前晚嘱其24：00前根据需要进食适量清淡半流质,术前2~3h口服5%葡萄糖液200ml;对照组患者术前晚20：00后禁食,24：00后禁水。比较两组患者术前口渴、饥饿、焦虑感及围术期空腹血糖、血清胰岛素、C肽、胰岛素抵抗指数,术后肝功能指标、并发症发生情况和住院天数等。结果观察组患者术前口渴、饥饿感较对照组有改善,差异均有统计学意义（均P〈0.05）。而观察组发生麻醉前血糖低于正常值、手术结束时高血糖者较对照组少,差异均有统计学意义（均P〈0.05）。观察组患者手术结束时血清C肽平均值高于对照组,术后胰岛素抵抗指数低于对照组,差异均有统计学意义（均P〈0.05）。结论缩短术前禁食、水时间可改善肝癌合并糖尿病患者术前口渴、饥饿感,对术后胰岛素抵抗有改善作用。Objective To explore a suitable fasting for solids and liquids program for liver cancer patients who combined with diabetes.Methods By convenience sampling,120 patients of liver cancer combined with diabetes were selected and e qually divided into observation group and control group according to the admission time.The observation group was given semi-fluid at midnight of the day before operation,and also given 5%GS（200 ml） 2 to 3 hours before operation.Control group was received fasting since 20：00 and forbidden to drink water since midnight before operation.Compare two groups of patients＇ thirst, hunger, anxiety feeling before operation, and perioperative fasting plasma glucose, fasting insulin, peptide C,insulin resistance index,preoperative liver function index,incidence of complications etc.Resuits The observation group patients＇ thirst,hunger level were lower than the control group （all P〈0.05）.The incidences of preoperative low blood sugar,and high blood sugar after surgery in observation group were less than which in control group （all P〈0.05）.Average score of postoperative C--peptide in observation group was higher than control group,while the insulin resistance index was lower than control group （all P〈0.05）. Conclusion Shorten the time of preoperative fasting for solids and liquids can alleviate thirst, hunger feeling of liver cancer patients combined with diabetes in preoperative period ,and it can also de crease the insulin resistance.

关 键 词：肝癌 糖尿病 禁食 禁水 低血糖 高血糖 胰岛素抵抗 

分 类 号：R735.7[医药卫生—肿瘤]