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中国临床研究英文版:2023,36(6):883-888
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基于加速康复外科理念术前口服10%葡萄糖对胃癌术后InsRβ蛋白及胰岛素抵抗的影响
(1. 咸宁市中心医院 湖北科技学院附属第一医院胃肠外科, 湖北 咸宁 437100;2. 咸宁市中心医院 湖北科技学院附属第一医院产科, 湖北 咸宁 437100)
Impacts of preoperative oral glucose 10% based on ERAS concept on postoperative InsRβ protein and insulin resistance in patients with gastric cancer
(1.Department of Gastrointestinal Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437100, China;2.Department of Obstetrical, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437100, China)
摘要
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Received:July 20, 2022   Published Online:June 20, 2023
中文摘要: 目的 分析基于加速康复外科(ERAS)理念术前口服10%葡萄糖对胃癌术后胰岛素受体β亚基(InsRβ)蛋白、胰岛素抵抗的影响。 方法 选择2020年3月至2022年3月在咸宁市中心医院治疗的80例胃癌患者,随机将患者分为常规组和ERAS组,各40例。常规组患者采用常规围手术期治疗方式,ERAS组患者采用加速康复外科理念进行治疗(包括术前12 h予以口服10%葡萄糖溶液500 mL)。对比两组患者手术相关指标、InsRβ、血糖、C-反应蛋白(CRP)、胰岛素、胰岛素抵抗指数(HOMA-IR)、并发症以及满意度。 结果 两组患者手术时间、术中出血量差异无统计学意义(P>0.05);ERAS组术后首次排气时间、进食流质时间、术后住院时间均优于常规组(P<0.01);术后1、3 d两组患者InsRβ蛋白表达量均降低,且ERAS组高于常规组(P<0.05),血糖、CRP、胰岛素、HOMA-IR水平均上升,ERAS组低于常规组(P<0.05);与术后1、3 d相比,术后7 d两组患者InsRβ蛋白表达量均升高,且ERAS组高于常规组(P<0.05),血糖、CRP、胰岛素、HOMA-IR水平降低,且ERAS组低于常规组(P<0.05);与常规组相比,ERAS组患者并发症发生率略低(2.50% vs 12.50%, χ2=2.882,P=0.089),术后满意度略高,但差异无统计学意义(97.5% vs 85.0%, χ2=2.505, P=0.114)。 结论 基于ERAS理念术前口服10%葡萄糖可缓解患者术后胰岛素抵抗,改善InsRβ蛋白水平,减少术后住院时间,有利于患者的康复。
Abstract:Objective To analyze the effects of preoperative oral 10% glucose based on enhanced recovery after surgery (ERAS) concept on insulin receptor β-subunit (InsRβ) protein level and insulin resistance in postoperative gastric cancer patients. Methods Eighty patients with gastric cancer undergoing surgical treatment in Xianning Central Hospital from March 2020 to March 2022 were randomly divided into routine group and ERAS group according to perioperative treatment (n=40, each) . The routine group patients were treated with conventional perioperative treatment, while the ERAS group patients were treated with the concept of ERAS (including oral administration of 500 mL of 10% glucose solution 2 hours before surgery) . The surgical related indicators, InsRβ, blood glucose, C-reactive protein (CRP) , insulin, homeostasis model assessment insulin resistance index (HOMA-IR) , complications and patients' satisfaction were compared between two groups. Results There was no significant difference in operation time and intra-operative bleeding between two groups (P>0.05) . The first exhaust time, the fluid intake time and postoperative hospital stay in ERAS group significantly shortened compared with those in routine group (P<0.01) . At 1 and 3 days after surgery, InsRβ protein level decreased in both groups and was statistically higher in ERAS group than that in routine group (P<0.05) . The levels of blood glucose, CRP, insulin and HOMA-IR increased in two groups and were significantly lower in ERAS group than those in routine group (P<0.05) . Compared with postoperative 1 and 3 days, the expression of InsRβ protein increased in both groups of patients 7 days after surgery and was higher in ERAS group than that in routine group (P<0.05) , and the levels of blood glucose, CRP, insulin and HOMA-IR decreased in two groups and were lower in ERAS group than those in routine group (P<0.05) . Compared with routine group, the incidence of complications in ERAS group was slightly lower without significant difference (2.50% vs 12.50%, χ2=2.882, P=0.089) , and postoperative satisfaction was slightly higher without significant difference (97.50% vs 85.00%, χ2=2.505, P=0.114) . Conclusion Preoperative oral administration of 10% glucose based on ERAS concept can effectively alleviate postoperative insulin resistance, improve InsRβ protein level and reduce postoperative hospital stay, which are conductive to the postoperative rehabilitation of the patients with the gastric cancer.
文章编号:     中图分类号:R735.2    文献标志码:B
基金项目:咸宁市中心医院湖北科技学院附属第一医院科研项目 (2021XYB026)
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