丙泊酚和七氟醚对Ⅱ型糖尿病胃癌患者麻醉中血糖和胰岛素的影响  

Effects of propofol and sevoflurane on the blood glucose and insulin of patients with gastric cancer combined with type Ⅱ diabetes mellitus during anesthesia

作　　者：孙正春 胡青烽[2] 

机构地区：[1]兰州市第一人民医院麻醉科,甘肃兰州730050 [2]甘肃省肿瘤医院麻醉科,甘肃兰州730050

出　　处：《中国肿瘤外科杂志》2017年第1期47-50,共4页Chinese Journal of Surgical Oncology

摘　　要：目的观察胃癌合并Ⅱ型糖尿病患者麻醉中血糖及胰岛素水平的变化规律,选择最适合的麻醉用药。方法选取兰州市第一人民医院及甘肃省肿瘤医院2014年1月至2015年12月胃癌合并Ⅱ型糖尿病患者168例,按完全随机法等分为A组与B组,分别采用丙泊酚(A组)与七氟醚(B组)麻醉。分别于麻醉诱导前5 min(t_1)、麻醉诱导后5 min(t_2)及麻醉后2 h(t_3)抽取中心静脉血,检测并比较两组的血糖、血清胰岛素及白细胞介素-6(IL-6)水平。结果麻醉诱导前两组患者的各项指标水平差异无统计学意义(P>0.05)。麻醉诱导后,两组在t_2及t_3的血糖、血清胰岛素及IL-6水平比较差异均有统计学意义(P<0.05);两组在各时间点的血糖浓度、血清胰岛素及IL-6水平组内比较差异也有统计学意义(P<0.05)。结论麻醉诱导后患者的血糖值及血清IL-6水平持续增加,血清胰岛素水平持续降低;丙泊酚对患者的刺激作用小于七氟醚,更适用于Ⅱ型糖尿病胃癌患者的手术麻醉。Objective To analyze the changes of blood glucose and insulin in patients with gastric cancer combined with type Ⅱ diabetes during anesthesia. Methods A total of 168 patients with gastric cancer combined with type Ⅱ diabetes in the First People＇s Hospital of Lanzhou City and Gansu Province Cancer Hospi- tal from January 2014 to December 2015 were selected and randomly divided into the experimental group A and the experimental group B. The experimental A and B group were anesthetized with propofol and sevoflurane, re- spectively. The central venous blood of the two experimental groups was extracted at 5 min （ tl ） before anesthe- sia induction, 5 min （t2） after anesthesia induction, and 2 h （t3 ） after anesthesia, respectively. Blood glu- cose, serum insulin and interleukin-6 （IL-6） levels were detected and compared between the two groups. Results There were no significant differences in each index level between the two groups before anesthesia induc- tion （P 〉 0.05）. After anesthesia induction, comparison of blood glucose, serum insulin, and IL-6 levels at t2 and t3 between the two groups had statistically difference （P 〈 0.05）. Comparison of the blood glucose, serum insulin, and IL-6 levels within the two groups was statistically significant （P 〈 0.05）. Conclusions After an- esthesia induction, the blood glucose and serum IL-6 levels of patients were continuously increased, and the ser- um insulin level was continuously decreased. The stimulating effect of propofol on patients was less than sevoflu- rane, which is more suitable for surgery anesthesia in patients with gastric cancer.

关 键 词：胃癌 Ⅱ型糖尿病 麻醉 血糖 胰岛素 丙泊酚 七氟醚 IL-6 

分 类 号：R614[医药卫生—麻醉学] R587.1[医药卫生—外科学] R735.2[医药卫生—临床医学]