腹腔镜下胆囊切除术患者术前口服10%葡萄糖溶液的效果分析

Effect Analysis of Oral Administration of 10%Glucose Solution before Laparoscopic Cholecystectomy

目的:探讨腹腔镜下胆囊切除术患者术前口服10%葡萄糖溶液的效果。方法:选取2020年12月-2021年5月黄梅县中医医院收治的择期行腹腔镜下胆囊切除术患者84例按照随机数字表法分为观察组和对照组,每组42例。对照组实施常规护理措施,观察组于手术前一晚22时及手术当日早6时分别口服10%葡萄糖溶液400、100 ml。观察两组手术应激反应、胰岛素抵抗、术后恢复情况及不良反应。结果:术后24 h,两组肾上腺素、皮质醇水平均较术前1 h升高,观察组均低于对照组,差异有统计学意义(P<0.05);观察组术后24 h空腹血清胰岛素、胰岛素抵抗指数与对照组比较,差异无统计学意义(P>0.05);观察组术后肛门排气时间、首次下床活动时间、住院时间均优于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(7.14%)低于对照组(23.80%),差异有统计学意义(P<0.05)。结论:腹腔镜下胆囊切除术患者术前口服10%葡萄糖溶液可降低手术应激反应,促进术后恢复,缩短住院时间,减少不良反应发生,但对于胰岛素抵抗无明显影响。

Objective:To investigate the effect of oral administration of 10%Glucose Solution before laparoscopic cholecystectomy.Method:Eighty-four patients with elective laparoscopic cholecystectomy admitted to Huangmei County Hospital of Traditional Chinese Medicine from December 2020 to May 2021 were divided into observation group and control group according to random number table method,with 42 cases in each group.The control group was given routine nursing measures,and the observation group was given 400 and 100 ml 10%Glucose Solution orally at 22:00 the night before the operation and 06:00 the day of the operation.Stress response,insulin resistance,postoperative recovery and adverse reactions were observed in the two groups.Result:24 hours after operation,the levels of adrenaline,cortisol in both groups were higher than those 1 hour before operation,but the observation group was lower than the control group,the differences were statistically significant(P<0.05).There were no significant differences in fasting serum insulin and insulin resistance index between the observation group and the control group(P>0.05).The anal exhaust time,first time of getting out of bed and hospitalization time of observation group were better than those of control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in observation group(7.14%)was lower than 23.80%in control group,the difference was statistically significant(P<0.05).Conclusion:Oral administration of 10%Glucose Solution before laparoscopic cholecystectomy can reduce the surgical stress response,promote postoperative recovery,shorten the length of hospital stay,and reduce the incidence of adverse reactions,but has no significant effect on insulin resistance.