全麻药对胃癌病人围术期血糖和胰岛素的影响

Influence of Anesthetics on Perioperative Blood Glucose and Insul in Levelsin Patients of Stomach Carcinoma

目的:观察丙泊酚(P)、依托咪酯(E)和异氟烷(I)对胃癌根治术病人围术期血糖和胰岛素的影响.方法:30例(ASAⅠ～Ⅱ级)拟行胃癌根治术病人随机分为P组、E组和I组,每组10名.于麻醉前5 min、麻醉后60 min和术后5 min抽取静脉血,分别测定血糖和血清胰岛素含量,另选10名健康成人为对照组.结果:实验组在麻醉前5 min血糖和胰岛素水平与对照组比较无统计学意义(P>0.05);麻醉后60 min和术后5 min血糖均高于麻醉前(P<0.05),胰岛素均低于麻醉前(P<0.05);麻醉前、后实验组血糖和胰岛素比较无统计学意义(P>0.05).结论:应激反应导致胃癌根治术病人围术期血糖升高,胰岛素分泌下降,P、E和I均不能显著影响这一过程.

Objective： To study the influence of propofol（P）, etomidate（E） and isoflurane（I）on blood glucose and insulin levels in patients of stomach carcinoma during the radical operation. Methods： Thirty patients（ASA Ⅰ-Ⅱ ）of stomach carcinoma undergoing radical operations were randomly divided into P, E and I groups. Blood samples were drawn from peripheral vein 5 minutes before anesthesia, 60 minutes after anesthesia and 5 minutes postoperatively. The blood glucose and the serum insulin were determined. Ten healthy individuals were used as control group. Results： There was no difference in blood glucose and insulin levels 5 minutes before anesthesia in P, E and I groups than control gronp（P〉0.05）. At 60 minutes after anesthesia and 5 minutes postoperatively the blood glucose was higher than that 5 minutes before anesthesia, the serum insulin was lower than that 5 minutes before anesthesia in P, E and I gronps（P〈0.05）. There was no difference on blood glucose and serum insulin level among P, E and I groups（P〉0.05）. Conclusion： The blood glucose increases and the serum insulin decreases during the radical operation of stomach carcinoma which caused by perioperative stress. P, E and I can not remarkably influence this process.