期刊文献+

围手术期补充含糖液体对手术患者血糖及胰岛素抵抗的影响 预览

Effects of Perioperative Period Infusion of Glucose-crystalloid on Patients' Blood Sugar and Insulin Resistance
在线阅读 下载PDF
收藏 分享 导出
摘要 目的:观察围手术期输注含糖和不含糖晶体液对血糖及胰岛素抵抗的影响。方法:择期2h左右全麻手术46例,年龄20~50岁,ASA分级Ⅰ~Ⅱ级,随机分为两组,手术期间全程输注钠钾镁钙葡萄糖注射液(含糖晶体液,G组)和输注乳酸钠林格注射液(不含糖晶体液,R组),每组23例;入手术室后两组病人用对应液体以10mL/(kg·h)的速度为基础静脉输注,由麻醉医师据术前禁食时间、术中不显性蒸发、术中失血情况调整输液速率;于麻醉诱导前(T1)、手术结束时(T2)测定血糖、血酮和胰岛素浓度,并计算胰岛素抵抗指数(IR)。结果:与R组比较,T1时G组血糖水平升高(P<0.05),但血糖值在正常范围内;胰岛素及IR比较,T1和T2时点两组差异均无统计学意义(P>0.05);与T1比较,R组在T2时点血酮水平升高(P<0.05);与R组比较,T2时G组血酮水平降低(P<0.05)。结论:围手术期短时间输注含糖晶体液(1%)能得到满意的血糖浓度和抑制脂肪分解,且不产生胰岛素抵抗。 Objective:To observe the effects of perioperative period replenish of glucose-crystalloid and no-glucose-crystalloid on patients' blood sugar and insulin resistance.Methods:Selecting 46 general anesthesia patients with operation time of abou T2 hours,aged 20 to 50 years old;ASA grade I-II,divided randomly into two groups with 23 in each group:sodium potassium magnesium calcium and glucose injection(glucose-crystalloid,group G) and injection of sodium lactate Ringer's injection(no-glucose-crystalloid,group R) during the whole surgery.After entering the operating room,both groups received injection at a rate of 10 mL/(kg·h) for intravenous infusion,and rate adjusted by the anesthetist according to the preoperative fasting time,intraoperative not dominant evaporation,intraoperative blood loss.Blood glucose,blood ketone and insulin concentrations were measured pre-anesthesia(T1) and at the end of the surgery(T2),and insulin resistance index(IR) was calculated.Results:Compared with the R group,the blood glucose level of group G was increased(P<0.05),but the blood glucose level was within the normal range.Comparing insulin and IR ,T1 and T2 time point of both groups showed no difference(P>0.05).Compared with T1,blood ketone levels of group R improved at T2 time point(P<0.05);compared with the group R,blood ketone levels of group G decreased at T2 time point(P<0.05).Conclusion:Infused crystalloid solution with glucose(1%) within short time during perioperative period can effectively control the blood glucose concentration and inhibit the decomposition of fat,and would not produce insulin resistance.
作者 刘艳秋 邱军 陈惠 任益民 曾丽 张凯强 LIU Yanqiu;QIU Jun;CHEN Hui;REN Yimin;ZENG Li;ZHANG Kaiqiang(Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Anesthesiology,Naiyong People's Hospital,Naiyong 553300,Guizhou,China)
出处 《贵州医科大学学报》 CAS 2019年第1期72-75,共4页 Journal of Guizhou Medical University
基金 贵州省卫生计生委科学技术基金资助项目(gzwjkj2017-1-083) 贵州省2017年大学生创新训练项目(201710660020).
关键词 围手术期 补液疗法 糖代谢 胰岛素 胰岛素抵抗 perioperative period crystalloid solution glucose metabolism insulin insulin resistance
作者简介 通信作者:陈惠,E-mail:809366108@qq.com
  • 相关文献

参考文献13

二级参考文献228

共引文献1228

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈