目的:探讨糖预处理对胃肠道肿瘤手术后血清胰岛素和C肽水平的影响.方法:选取60例胃肠道肿瘤择期手术患者,采用数字表分法随机将其分为治疗组和对照组,每组30例.治疗组患者术前给予糖预处理,即麻醉前2 h口服含50 g葡萄糖的碳水化合物300 ml;对照组患者按传统方法进行,术前12 h禁食,术前6 h禁饮.分别于术前3 h、术后l d、3 d和7 d抽取两组患者外周血,监测空腹血糖(FBG)、空腹胰岛素(FINS)定量,空腹C肽(C-P)定量.结果:术后第1 d、3 d对照组FBG和CP水平明显高于治疗组,两组比较差异有统计学意义(t=5.565,t=3.318;P＜0.05);术后第7 d治疗组FBG、FINS及CP水平接近术前,而对照组术后第1 d、3 d和7 d的FINS水平高于治疗组,差异有统计学意义(t=4.700,t=4.374,t=4.347;P＜0.05.结论:胃肠肿瘤患者术前给予糖预处理,对于胃肠肿瘤手术后胰岛素和C肽水平能够产生影响,可缩短胃肠道肿瘤手术后胰岛素抵抗的时间.%Objective: To investigate the effects of pretreatment glucose for levels of postoperative insulin and C-peptide of patients with gastroenteric tumor. Methods: 60 patients with gastroenteric tumor who were in term of selective operation were divided into treatment group (n=30) and control group (n=30) as random number method. Patients of treatment group received pretreatment glucose (took orally 300mL carbohydrate contained 50 g glucose at 2 hours pre-anesthetization), and ones of control group received conventional method (fasting 12hours pre-operation, and water-deprivation 6 hours pre-operation). The peripheral blood of patients were blooded at 3hours pre-operation, 1 day post-operation, 3 days post-operation and 7 days post-operation so as to monitor fasting blood-glucose (FBG), quantity of fasting insulin (FINS) and quantity of fasting C- peptide (C-P). Results: At the post operation 1 day and 3 days, the levels of FBG and CP of control group were significantly higher than that of treatment group (t=5.565, t=3.318, P<0.05), and the levels of FBG, FINS and CP post operation 7 days were closed to preoperative levels of treatment group, respectively. While the levels of FINS post operation 1 day, 3 days and 7 days of control group were significantly higher than that of treatment group (t=4.700, t=4.374, t=4.347, P<0.05), respectively. Conclusion: The pretreatment of glucose for patients with gastroenteric tumor can affect the levels of postoperative insulin and C-P of patients, and shorten the time of post operation insulin resistance.
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