高渗盐水对结肠癌患者术后应激性高血糖的作用

Effect of hypertonic saline on postoperative stress hyperglycemia in patients with colon cancer

目的:探讨高渗盐水对结肠癌术后应激性高血糖的作用。方法:收集61例无糖尿病病史的结肠癌手术患者,术后均出现应激性高血糖。随机分为实验组30例和对照组31例,实验组术后给予小容量高渗盐水液体治疗,对照组给予等容量的生理盐水,观察术后24、48、72 h空腹血糖、胰岛素及IL-1、IL-6的水平,计算胰岛素抵抗指数(lnHOMA-IR)。结果:术后24、48、72 h,实验组的空腹血糖、胰岛素水平及ln HOMA-IR均显著低于对照组(均P<0.01);IL-1及IL-6的水平显著低于对照组(P<0.05);平均术后住院日少于对照组(P<0.05);术后并发症发生率如感染、吻合口瘘,与对照组比较无显著性差异(P>0.05)。结论:小容量高渗盐水治疗可以改善结肠癌术后的应激性高血糖,促进患者的术后恢复。

Objective To evaluate the effect of hypertonic saline on the postoperative stress hyperglycemia in patients with colon cancer. Methods： Sixty-one patients with postoperative stress hyperglycemia enrolled into this study were randomly divided into the experimental group（ 30 cases） and the control group（ 31 cases）. The experimental group received postoperative small volume hypertonic saline fluid therapy,and the control group was given equal volume of normal saline. The levels of fasting blood glucose,insulin,IL-1 and IL-6 were determined at 24,48 and 72 h after operation in both two groups,then ln HOMA-IR was calculated. Results： The levels of fasting blood glucose,insulin and ln HOMA-IR in the experimental group at 24,48 and 72 h after operation were significantly lower than those in the control group（ P〈0. 01）. The levels of IL-1 and IL-6 in the experimental group at 24,48 and 72 h after operation were significantly lower than those in the control group（ P〈0. 05）. The postoperative hospital stay in the experimental group was significantly shorter than that in the control group（ 10. 1 ± 2. 2 vs 11. 5 ± 2. 1 days,P〈0. 05）. There was no significant difference in the incidence of postoperative complications between the experimental group and the control group（ P〈0. 05）. Conclusion： The small volume hypertonic saline fluid therapy could reduce the postoperative stress hyperglycemia and speed up the recovery in patients with colon cancer.