围手术期胰岛素抵抗及麻醉管理研究进展  

Advances in perioperative insulin resistance and anesthesia management

作　　者：刘凡凡 周燕丰[1] Liu Fanfan;Zhou Yanfeng(Department of Anesthesiology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属第一医院麻醉科,杭州310006

出　　处：《国际麻醉学与复苏杂志》2020年第11期1091-1095,共5页International Journal of Anesthesiology and Resuscitation

基　　金：浙江省科技厅课题(391010-I50904)。

摘　　要：胰岛素抵抗(insulin resistance,IR)是围手术期常见的并发症之一,严重影响着患者的预后,其机制主要与神经内分泌及炎症因子直接或间接干扰胰岛素作用通路有关。麻醉药物及麻醉方式的选择不同程度地影响着患者术后的转归,但其对围手术期IR的影响尚存在争议。文章主要阐述围手术期IR的流行病学及发生机制,并介绍了麻醉方式及麻醉药物对其的影响,对围手术期血糖管理的最新进展进行了综述,以期为预防围手术期IR的发生提供参考依据。Insulin resistance(IR)is one of the common complications during the perioperative period,usually accompanied by elevated blood glucose,which seriously affects the prognosis of patients.Its mechanism is mainly related to neuroendocrine and inflammatory factors directly or indirectly interfering with insulin pathway.The choice of anesthetics and anesthesia methods affect the outcome of patients after surgery,but the effect on perioperative IR remains controversial.This article mainly expounds the epidemiology and mechanism of perioperative IR,and introduces the anesthetic methods and the influence of narcotic drugs on it,and summarizes the latest progress of perioperative blood glucose management,in order to provide reference for the prevention of perioperative IR.

关 键 词：胰岛素抵抗 肿瘤坏死因子-Α 丙泊酚 吸入麻醉药 右美托咪定 胰岛素疗法 

分 类 号：R614[医药卫生—麻醉学]