腹腔镜手术对腹型肥胖直肠癌患者术后代谢影响的研究

Metabolism influence of laparoscopic surgery on postoperative rectal cancer patients with abdominal obesity

目的观察腹型肥胖直肠癌患者术后胰岛素抵抗的特点及腹腔镜手术对术后胰岛素抵抗的影响。方法随机选择择期手术的直肠癌患者62例为研究对象，测量术前腰围、术后第1天空腹血糖和胰岛素。稳态模式评估法计算胰岛素抵抗指数。结果腹型肥胖患者术后胰岛素抵抗指数高于非腹型肥胖患者，腹腔镜组患者胰岛素抵抗指数低于开腹组。结论腹型肥胖直肠癌患者术后易发生代谢紊乱，腹腔镜手术能够降低术后胰岛素抵抗程度。

Objective To observe the features of insulin resistance（IR） on postoperative rectal cancer patients with abdominal obesity and the influence of laparoscopic surgery on insulin resistance. Methods 62 patients with rectal cancer selected randomly were invited to participate. Waist circumference was performed preoperatively,fasting blood glucose （FBG） and fasting insulin （FINS） were assayed on the 1 st day postoperatively. Insulin resistance was evaluated by the method of homeostasis model assessment （HOMA）. Results lnHOMA-IR of patients with abdominal obesity was higher than that of patients with no abdominal obesity, lnHOMA-IR of patients undergoing laparoscopic surgery was lower than that of patients undergoing laparotomy. Conclusion Metabolic disorder occurs more easily in rectal cancer patients with abdominal obesity postoperatively, laparoseopic surgery can degrade the degree of insulin resistance.