术前口服糖溶液对胃癌手术患者胰岛素抵抗和氧化应激的影响

The influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery

目的探讨术前口服糖溶液对胃癌手术患者胰岛素抵抗和氧化应激的影响。方法将63例胃癌手术患者根据随机数字表法分为观察组（n=32）和对照组（n=31），2组术前1天晚10点后禁食，术前3 h观察组患者口服500 ml 100 g/L的葡萄糖溶液，对照组口服等量蒸馏水。记录2组一般资料和手术指标，分别于术前4 h和手术结束后取静脉血，测定血糖（GLU）、胰岛素（insulin）、丙二醛（MDA）和超氧化物歧化酶（SOD）水平，计算胰岛素抵抗指数（HOMA-IR）。结果2组术前4 h的一般资料比较差异均无统计学意义，具有可比性（P均〉0.05）；2组均顺利完成试验，治疗期间均未发生呛咳、误吸等并发症；2组手术时间、术中补液量、术中出血量、术后病理分期比较差异均无统计学意义（P均〉0.05）。与术前比较，术后2组GLU、胰岛素和HOMA-IR均显著上升，差异有统计学意义（P均〈0.05）；观察组术后GLU、胰岛素和HOMA-IR显著低于对照组，差异有统计学意义（P〈0.05）。与术前比较，术后2组SOD和MDA均显著上升，差异有统计学意义（P〈0.05）；观察组术后SOD显著高于对照组，MDA显著低于对照组，差异有统计学意义（P〈0.05）。结论胃癌手术患者术前口服糖溶液能降低胰岛素抵抗，减轻氧化应激，且安全性高。

Objective To explore the influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery.Methods63 cases of castric cancer patients undergoing surgery were divided into observation group （n=32） and the control group （n=31） according to random number table method. Patients were given fasting after ten o’clock the day before surgery. Patients in the observation group were dealed with 500 ml 100 g/L glucose solution orally, while patients in the control group were dealed with the same amount of distilled water 3 hours before surgery. The general information and operation indicators were recorded. Blood glucose （GLU） , insulin, malondialdehyde （MDA） and superoxide dismutase （SOD） levels were detected before surgery and 4 hours after surgery. Insulin resistance index （HOMA-IR） was recorded also.ResultsThe general data between the two groups before the test started had no statistically significant difference （P〉0.05） . All patients completed test successfully, and the complications such as choking cough, aspiration did not happen during the treatment. The operation time, Intraoperative fluid infusion, intraoperative blood loss and postoperative pathological stage between the two groups had no statistical difference （P〉0.05） . GLU, insulin and HOMA-IR in the two groups after surgery increased significantly than those before surgery, and the difference had statistical significance （P〈0.05） . GLU, insulin and HOMA-IR were significantly lower in the observation group than in the control group, and the difference had statistical significance （P〈0.05） . SOD and MDA in the two groups after surgery increased significantly than those before surgery, and the difference had statistical significance （P〈0.05） . SOD in the observation group was significantly higher, while MDA was significantly lower than those in the control group, and the difference had statistically significance （P〈0.05） .ConclusionOral administration of glucose before surgery in castric cancer patients undergoing surgery can reduce insulin resistance and oxidative stress, and it is safe.