术前口服碳水化合物对日间腹腔镜胆囊切除术后患者的疗效分析

Preoperative oral carbohydrate intake in patients undergoing LC day surgery

目的分析日问手术腹腔镜胆囊切除的患者术前口服碳水化合物的安全性及对生活质量的影响。方法将解放军总医院2016年10月至2017年3月问行日间腹腔镜胆囊切除术患者117例随机分为ABE三组，每组39例患者。A组术前口服碳水化合物，B组术前经静脉输注等同A组热量的葡萄糖，c组术前隔夜禁食水。观察三组患者的术前口渴情况、分析各组患者术后的炎症指标、心率、血糖、血清胰岛素、胰岛素抵抗指数，比较三组围手术期情况。结果所有患者均未发生麻醉误吸，未发生ClavienI级以上并发症，A组和B组胰岛素抵抗指数、空腹血清胰岛素比较差异有统计学意义（Z=-5．60，-4．78，P〈0．05），A组和c组问胰岛素抵抗指数、空腹血清胰岛素、降钙素原比较差异有统计学意义（Z=-2．65，-2．49，-4．02，P〈0．05），B组和C组降钙素原比较差异有统计学意义（Z=-2．183，P〈0．05）。A组和B组、c组患者术前口渴程度比较，差异有统计学意义（χ^2=6．47，P〈0．05）。结论接受日问手术腹腔镜胆囊切除的患者术前口服碳水化合物是安全可行的，有利于提高患者的生活质量。

Objective To evaluate preoperative oral carbohydrate in patients receiving LC day surgery. Methods 117 patients undergoing LC day surgery in PLA General Hospital from Oct 2016 to Mar 2017 were evenly divided into three groups. Patients in group A took oral carbohydrate preoperatively, group B by iv glucose, group C by overnight fasting. The preoperative thristy and the indicators of inflammation, heart rate, blood glucose, serum insulin, insulin resistance index postoperatively were collected and compared. Results No patients suffered aspiration. There were no complications above Clavien I level. Differences in insulin resistance index, fasting serum insulin were statistically significant between group A and group B （ Z = - 5.60, - 4.78, P 〈 0.05 ）. That of insulin resistance index, fasting serum insulin and proealcitonin between group A and group C were statistically significant （ Z = - 2. 65, - 2.49, - 4.02, P 〈 O. 05 ）. Proealcitonin between group B and group C were statistically different （ Z = -2. 183,P 〈 0. 05）. The preoperative thristy between group A and group B, group C were statistically different （X^2= 6. 47 ,P 〈 0. 05 ）. Conclusions Preoperative oral carbohydrate intake is safe and feasible with the benefits of improving the quality of life in patients operated on LC day surgery.