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腹腔镜胆囊切除术患者碳水化合物负荷对临床结果和代谢反应的评估。

Evaluation of carbohydrate loading on clinical results and metabolic responses in patients undergoing laparoscopic cholecystectomy.

作者信息

Tavalaee Mahdi, Beigi Ehsan, Karbalaeikhani Ali, Shirzadi Alireza, Ahmadinejad Izadmehr

机构信息

Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Department of Surgery, School of Medicine, Emam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran.

出版信息

Ann Med Surg (Lond). 2022 Jun 8;78:103963. doi: 10.1016/j.amsu.2022.103963. eCollection 2022 Jun.

Abstract

OBJECTIVE

Insulin resistance is associated with a number of postoperative complication and delays recovery. Carbohydrate rich drinks given preoperatively may decrease these deleterious effects. This study evaluated the clinical effects of a preoperative carbohydrate loading in patients undergoing laparoscopic cholecystectomy.

METHODS

In this a randomized clinical trial conducted at (XXX) Medical Center located, patients undergoing elective cholecystectomy were included. Patients were randomly divided into fasting and dextrose-receiving groups. The outcomes of this study are the pain, pre- and postoperative blood sugar, fasting blood sugar, insulin, cortisol, albumin, CRP (c-reactive protein), and wound conditions such as wound infection and the amount of fluid discharge from the drain. The data was statistically analyzed using SPSS v22.

RESULTS

Patients who received carbohydrates before surgery experienced less pain on the day after surgery (P-value <0.05). Insulin resistance, CRP, CRP to albumin ratio and cortisol levels were significantly reduced in dextrose group (P-value <0.05) However, difference in glucose levels and albumin was not significant in the two groups.

CONCLUSION

The present results show that although carbohydrate loading is associated with reduced postoperative pain and reduction in inflammatory factors along with insulin resistance.

摘要

目的

胰岛素抵抗与多种术后并发症相关,并会延迟恢复。术前给予富含碳水化合物的饮料可能会减少这些有害影响。本研究评估了术前碳水化合物负荷对接受腹腔镜胆囊切除术患者的临床效果。

方法

在位于(XXX)的医学中心进行的这项随机临床试验中,纳入了接受择期胆囊切除术的患者。患者被随机分为禁食组和接受葡萄糖组。本研究的结果包括疼痛、术前和术后血糖、空腹血糖、胰岛素、皮质醇、白蛋白、CRP(C反应蛋白)以及伤口状况,如伤口感染和引流管的液体引流量。使用SPSS v22对数据进行统计分析。

结果

术前接受碳水化合物的患者在术后第一天疼痛较轻(P值<0.05)。葡萄糖组的胰岛素抵抗、CRP、CRP与白蛋白比值和皮质醇水平显著降低(P值<0.05)。然而,两组的血糖水平和白蛋白差异不显著。

结论

目前的结果表明,尽管碳水化合物负荷与术后疼痛减轻、炎症因子减少以及胰岛素抵抗降低有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da49/9207142/dc76b0bda8d1/gr1.jpg

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