术前不同禁食时间对结肠癌根治性切除术后胰岛素抵抗的影响

The effect of different preoperative fasting time on postoperative insulin resistance in radical resection for colon cancer

目的探讨不同术前禁食时间对结肠癌根治性切除术后胰岛素抵抗的影响。方法回顾性分析77例结直肠癌根治性切除术患者,将手术患者分为术前禁食时间>12 h(A组)、8 h^12 h(B组)、4 h^8 h(C组)3个组。分析各组围手术期(术前、术后第1 d、术后第3 d和术后第7 d)的空腹血糖、胰岛素浓度,并计算各组胰岛素抵抗指数,评价患者的胰岛素抵抗情况。结果在结肠癌根治性切除术后第1 d和第3 d,B组和C组患者空腹血糖浓度、胰岛素浓度、胰岛素抵抗指数明显低于A组,差异有统计学意义(P<0.01);而在术后第7 d,这些指标3组间差异无统计学意义。结论延长术前禁食时间可增加术后胰岛素抵抗程度,术前禁食>12 h可增加术后胰岛素抵抗的风险。

Objective To study the effect of different preoperative fasting time on postoperative insulin resistance in radical resection for colon cancer. Methods To retrospectively analyze 77 patients with radical resection for colorectal cancer,who were divided into three groups of preoperative fasting time〉12 h（ A group）,8 h- 12 h（ B group）,4 h- 8 h（ C group）. The blood glucose and insulin levels were valued in each group before surgery,at the first day,third day,and seventh day after surgery,and insulin resistance index was calculated to evaluate patients with insulin resistance. Results The fasting blood glucose concentrations,insulin concentrations and insulin resistance index were significantly lower in B group and C group than in A group in the first day and the third day after radical resection of colon cancer,and the differences were statistically significant（ P〈0. 01）. But there was no statistical significane on the differences among the 3 groups in the seventh day after operation.Conclusion The postoperative insulin resistance increased with lengthening the preoperative fasting time,and preoperative fasting for more than 12 h can increase the risk of postoperative insulin resistance.