术前口服葡萄糖溶液对胃癌患者围手术期的影响研究  

Effect of Preoperative Oral Glucose Solution on Perioperative Period of Gastric Cancer Patients

作　　者：翟晓清 杨婕[1] 蒋理立[1] Zhai Xiaoqing;Yang Jie;Jiang Lili(Department of Gastrointestinal Surgery,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院胃肠外科,成都610041

出　　处：《成都医学院学报》2021年第2期169-172,共4页Journal of Chengdu Medical College

摘　　要：目的讨论胃癌手术患者术前口服葡萄糖溶液对患者围手术期的影响。方法选取2018年1月至2019年10月于四川大学华西医院诊治的100例胃癌患者为研究对象,按照随机数字表法分为对照组和试验组,每组50例。对照组患者术前常规禁食、禁饮;试验组患者在术前常规禁食、禁饮基础上,于手术前1d22∶00及手术当日6∶00分别口服5%葡萄糖溶液250 mL。两组患者分别于术前、术后检测血糖水平,评估胰岛素抵抗指数(HOMA-IR)、误吸发生率、反流误吸风险、排气时间和住院时间。结果试验组患者术前第2次检测血糖水平为(7.23±0.90)mmol/L,高于对照组的(5.04±0.83)mmol/L;试验组患者术后血糖、HOMA-IR分别为(8.41±0.97)mmol/L、(7.74±1.03)%,低于对照组的(9.95±1.02)mmol/L、(13.38±1.14)%,差异有统计学意义(P<0.05);试验组患者术前口渴、术前饥饿发生率分别为22.00%和32.00%,均低于对照组的72.00%和66.00%,差异有统计学意义(P<0.05);两组患者误吸风险程度比较,差异无统计学意义(P>0.05);试验组患者排气时间、住院时间分别为(2.10±0.39)d、(7.27±0.94)d,低于对照组的(2.89±0.41)d、(9.60±0.98)d,差异有统计学意义(P<0.05)。结论胃癌手术患者术前口服葡萄糖溶液,能够减轻术后应激性高血糖的发生和胰岛素抵抗,改善患者饥渴感,促进早期胃肠道功能恢复。Objective To discuss the effect of preoperative oral glucose solution on perioperative period in patients with gastric cancer.Methods A total of 100 patients with gastric cancer treated in West China Hospital of Sichuan University from January 2018 to October 2019 were selected and divided into control group(n=50)and experimental group(n=50)according to random number table method.Patients in the experimental group were given 250 mL 5% glucose solution at 22∶00 the day before operation and at 6∶00 a.m.on the day of surgery.And patients in both groups were given routine solid food fasting and liquid fasting.Blood glucose levels were measured before and after operation.Insulin resistance index(HOMA-IR),incidence of aspiration,reflux aspiration risk,exhaust time and length of hospital stay of patients in both groups before and after surgery were evaluated.Results The second blood glucose level of the experimental group before operation was(7.23±0.90)mmol/L,which was higher than that of the control group(5.04±0.83)mmol/L,while the postoperative blood glucose of the experimental group was(8.41±0.97)mmol/L,which was lower than that of the control group(9.95±1.02)mmol/L,the differences were statistically significant(P<0.05).The postoperative HOMA-IR of the experimental group was(7.74±1.03)%,which was lower than that of the control group(13.38±1.14)%,the difference was statistically significant(P<0.05).The incidence of preoperative thirst and hunger in the experimental group were22.00% and 32.00%,respectively,which were lower than 72.00% and 66.00% in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of aspiration between the two groups(P>0.05).The exhaust time and length of hospital stay in the experimental group were(2.10±0.39)d and(7.27±0.94)d,respectively,which were lower than(2.89±0.41)d and(9.60±0.98)d in the control group,the differences were statistically significant(P<0.05).Conclusion Oral glucose solution befo

关 键 词：胃癌 葡萄糖 围手术期 预后 胰岛素抵抗 

分 类 号：R735.2[医药卫生—肿瘤]