本文選題：婦科手術(shù)　切入點(diǎn)：葡萄糖溶液　出處：《蘇州大學(xué)》2016年碩士論文

【摘要】：目的:比較術(shù)前3小時(shí)口服或靜滴10%葡萄糖溶液對(duì)婦科手術(shù)患者圍術(shù)期胰島素抵抗的不同影響。方法:選取2015年1-12月間擬行擇期經(jīng)腹全子宮+雙側(cè)輸卵管切除術(shù)患者60例,按隨機(jī)數(shù)據(jù)表法隨機(jī)分為常規(guī)禁飲組、口服糖水組及靜滴糖水組,每組20例。禁飲組:術(shù)前常規(guī)禁食、禁飲8-12小時(shí);口服糖水組:術(shù)前3小時(shí)口服10%葡萄糖溶液300ml;靜滴糖水組:術(shù)前3小時(shí)靜滴10%葡萄糖溶液300ml。手術(shù)采用靜吸復(fù)合全身麻醉維持,術(shù)畢予以靜脈持續(xù)鎮(zhèn)痛。用視覺(jué)模擬評(píng)分法VAS測(cè)定三組患者的主觀舒適度,同時(shí)麻醉前留置胃管觀察患者胃內(nèi)殘留量。分別檢測(cè)患者術(shù)前3小時(shí)、麻醉前、術(shù)畢、術(shù)后第1天和術(shù)后第3天的外周血葡萄糖、胰島素水平,利用穩(wěn)態(tài)模式評(píng)估法HOMA測(cè)定胰島素抵抗指數(shù)(HOMA-IR)和胰島素敏感指數(shù)(HOMA-ISI)。結(jié)果:1)術(shù)前3小時(shí)口服10%葡萄糖溶液未顯著增加術(shù)前胃內(nèi)殘留量(P0.05);口服及靜滴10%葡萄糖溶液可明顯減輕患者的口渴感和饑餓感(P0.01);2)術(shù)畢、術(shù)后第1、3天口服及靜滴糖水組的胰島素抵抗(IR)程度均明顯低于常規(guī)禁飲組(P0.05)而胰島素敏感性(ISI)則高于常規(guī)禁飲組(P0.01);3)靜滴糖水組與口服糖水組在術(shù)畢、術(shù)后第1、3天的胰島素抵抗程度及胰島素敏感性無(wú)明顯差異。結(jié)論:術(shù)前3小時(shí)給予的兩種300m L10%葡萄糖溶液預(yù)處理方法對(duì)婦科手術(shù)患者是安全的,均可緩解術(shù)前的口渴感和饑餓感,減輕術(shù)后胰島素抵抗。
[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.

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R614

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 高星;;不同術(shù)前預(yù)處理方式改善術(shù)后胰島素抵抗的效果比較[J];現(xiàn)代儀器與醫(yī)療;2017年06期

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本文編號(hào)：1665598