后腹腔镜手术对胰岛素抵抗的影响

Effects of Retroperitoneal Laparoscopic on Insulin Resistance

目的:探讨后腹腔镜手术对胰岛素抵抗的影响。方法:将41例行腹膜后手术患者分为后腹腔镜组21例,开放手术组20例。分别于术前及手术结束后,术后第1、3天抽取静脉血检测胰岛素(FINS)、血糖(FBG),用QUICKI法计算胰岛素抵抗指数(HOMA-IR)、胰岛分泌指数(HOMA-β)、胰岛素敏感指数(ISI)。比较分析2组上述指标的变化差异。结果:①两组患者组内比较:术前与术后、术后24 h、术后72 h HOMA-IR差异均有统计学恴义(P<0.01);术前与术后、术后24 h ISI均差异有统计学恴义(P<0.01)。②两组患者组间比较术前、术后72 h HOMA-IR、HOMA-β、ISI差异均无统计学恴义(P>0.05),术后和术后24 h HOMA-β差异无统计学恴义(P>0.05),术后和术后24 h HOMA-IR、ISI差异有统计学恴义(P<0.01)。结论:与开放手术相比,泌尿外科后腹腔镜手术对胰岛素抵抗的影响较小,有利于患者的康复。

Objective：To investigate the effect of reptroperitoneal laparoseopic operation on insulin resistance. Methods： Forty-one cases were divided into two groups according to the operative way, retroperitoneal laparoscopie operation（21） ,and open operation（20）. Blood samples were taken preoperatively and at the end of the surgery. The following parameters were measured and compared within each group and between groups： preoperative and postoperative glucose, insulin, insulin resistance index, insulin secretion index and insulin sensitivity index. Results： Comparison between two groups of patients：RL group and O group preoperative and postoperative 72hours insulin resistance index,insulin secretion index,insulin sensitivity index was no significant difference（P〉0.05） ;Postoperative and 24 hours insulin secretion index was no significant difference（P〉0.05） ;Postoperative and 24 hours Insulin resistance index,insulin sensitivity index were significantly different（P〈0.01 ）. Conclusions： Compared with the conventional operation,retroperitoneal laparoseopie operation can significantly reduce postoperative IR.