术前口服或静滴10%葡萄糖溶液对妇科手术患者围术期胰岛素抵抗的影响

发布时间：2018-03-26 00:45

本文选题：妇科手术　切入点：葡萄糖溶液　出处：《苏州大学》2016年硕士论文

【摘要】：目的:比较术前3小时口服或静滴10%葡萄糖溶液对妇科手术患者围术期胰岛素抵抗的不同影响。方法:选取2015年1-12月间拟行择期经腹全子宫+双侧输卵管切除术患者60例,按随机数据表法随机分为常规禁饮组、口服糖水组及静滴糖水组,每组20例。禁饮组:术前常规禁食、禁饮8-12小时;口服糖水组:术前3小时口服10%葡萄糖溶液300ml;静滴糖水组:术前3小时静滴10%葡萄糖溶液300ml。手术采用静吸复合全身麻醉维持,术毕予以静脉持续镇痛。用视觉模拟评分法VAS测定三组患者的主观舒适度,同时麻醉前留置胃管观察患者胃内残留量。分别检测患者术前3小时、麻醉前、术毕、术后第1天和术后第3天的外周血葡萄糖、胰岛素水平,利用稳态模式评估法HOMA测定胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(HOMA-ISI)。结果:1)术前3小时口服10%葡萄糖溶液未显著增加术前胃内残留量(P0.05);口服及静滴10%葡萄糖溶液可明显减轻患者的口渴感和饥饿感(P0.01);2)术毕、术后第1、3天口服及静滴糖水组的胰岛素抵抗(IR)程度均明显低于常规禁饮组(P0.05)而胰岛素敏感性(ISI)则高于常规禁饮组(P0.01);3)静滴糖水组与口服糖水组在术毕、术后第1、3天的胰岛素抵抗程度及胰岛素敏感性无明显差异。结论:术前3小时给予的两种300m L10%葡萄糖溶液预处理方法对妇科手术患者是安全的,均可缓解术前的口渴感和饥饿感,减轻术后胰岛素抵抗。
[Abstract]:Objective: To compare the preoperative 3 hours of oral or intravenous infusion of 10% glucose solution on patients undergoing gynecological surgery effect of postoperative insulin resistance. Methods: from 2015 1-12 months undergoing elective abdominal hysterectomy plus bilateral tubal resection in 60 patients, according to random data table method were randomly divided into conventional drink group. Oral sugar group and intravenous sugar group, 20 cases in each group. Drink group: routine preoperative fasting, water deprivation for 8-12 hours; oral sugar group: before 3 hours of oral 10% glucose solution 300ml; intravenous sugar group: before 3 hours intravenous infusion of 10% glucose solution 300ml. surgery general anesthesia maintenance after operation, given intravenous continuous analgesia. Using visual analogue scale VAS determination of three groups of patients with subjective comfort at the same time, indwelling gastric tube before anesthesia were observed in the stomach. The residues were detected in 3 hours, patients with preoperative anesthesia before surgery, third days postoperative day and after first The peripheral blood glucose, insulin levels, insulin resistance index evaluation method of HOMA determination by using steady state model (HOMA-IR) and insulin sensitivity index (HOMA-ISI). Results: 1) 3 hours before the operation of oral 10% glucose solution did not significantly increase the preoperative gastric residual volume (P0.05); oral and intravenous infusion of 10% glucose solution can significantly reduce the patients with thirst and hunger (P0.01); 2) postoperative 1,3 days after operation of oral and intravenous sugar group of insulin resistance (IR) were significantly lower than that of the conventional water deprivation group (P0.05) and insulin sensitivity (ISI) is higher than that of normal group drink (P0.01); 3) static drop sugar group and glucose group at the end of operation, 1,3 days after the surgery the degree of insulin resistance and insulin sensitivity had no significant difference. Conclusion: 3 hours before operation to two 300m L10% glucose solution pretreatment method is safe for patients undergoing gynecological surgery, can relieve preoperative thirst and hunger The feeling of hunger relieved the postoperative insulin resistance.

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R614

【引证文献】