高渗盐水对结肠癌患者术后应激性高血糖的作用
Effect of hypertonic saline on postoperative stress hyperglycemia in patients with colon cancer.Wang Jianxiang Shen Jun Zhu Meng Fan Yuan Zhou Rui

王建祥,沈俊,竹梦,范渊,周锐.高渗盐水对结肠癌患者术后应激性高血糖的作用[J].内科急危重症杂志,2016,22(4):

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英文关键词:Hypertonic saline Colon cancer Postoperative stress hyperglycemia

基金项目:2011年武汉市卫生与计划生育委员会（WX11C19）

作者	单位	E-mail
王建祥	华中科技大学同济医学院附属普爱医院综合外科湖北武汉 430000	fy.kid@hotmail.com
沈俊	华中科技大学同济医学院附属普爱医院综合外科湖北武汉 430000
竹梦	华中科技大学同济医学院附属普爱医院综合外科湖北武汉 430000
范渊	华中科技大学同济医学院附属普爱医院综合外科湖北武汉 430000	fy.kid@hotmail.com
周锐	华中科技大学同济医学院附属普爱医院综合外科湖北武汉 430000	fy.kid@hotmail.com

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中文摘要:

【】目的探讨高渗盐水对结肠癌术后应激性高血糖的作用。方法选取61例术前无糖尿病史、术后出现应激性高血糖的结肠癌手术患者,随机分为实验组(30例)和对照组(31例),实验组术后接受小容量高渗盐水液体治疗,对照组则为等体积的生理盐水,观察术后24h、48h、72h空腹血糖、胰岛素及IL-1、IL-6的水平,计算lnHOMA-IR。结果 (1) 术后24h,48h,72h,实验组的空腹血糖、胰岛素水平及lnHOMA-IR均显著低于对照组(P＜0.01)；(2) 实验组术后IL-1及IL-6的水平显著低于对照组(P＜0.05)；(3) 实验组平均术后住院日少于对照组(10.1±2.2 vs 11.5±2.1,P＜0.05)；(4) 实验组术后并发症发生率：感染6.7%(2/30),对照组术后并发症发生率：感染6.5%(2/31)、吻合口瘘3.2%(1/31),两组间无显著性差异(P＞0.05)。结论小容量高渗盐水治疗可以改善结肠癌术后的应激性高血糖。

英文摘要:

Objective To evaluate the effect of hypertonic saline on the postoperative stress hyperglycemia in patients with colon cancer. Methods 61 patients with postoperative stress hyperglycemia were enrolled into this study, and were randomly divided into the experimental group (30 cases) and the control group (31 cases). The experimental group received postoperative small volume hypertonic saline fluid therapy, while the control group received equal volume of normal saline. The levels of fasting blood glucose, insulin, IL-1 and IL-6 of the two groups 24 hours ,48 hours and 72 hours after operation were observed and recorded, then lnHOMA-IR was calculated. Results (1) The levels of fasting blood glucose, insulin and lnHOMA-IR of the experimental group 24 hours ,48 hours and 72 hours after operation were significantly lower than the control group (P＜0.01). (2) The levels of IL-1 and IL-6 of the experimental group 24 hours ,48 hours and 72 hours after operation were significantly lower than the control group (P＜0.05). (3) The length of postoperative hospital stay of the experimental group was less than the control group(10.1±2.2 vs 11.5±2.1,P＜0.05). (4) There was no significant difference in the incidence of postoperative complications in the experimental group and the control group (P＜0.05). Conclusion The small volume hypertonic saline fluid therapy could reduce the postoperative stress hyperglycemia in patients with colon cancer.