Li Hongqiong, Zhao Yang, Wang Yizheng, Chen Changlin
Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College Nanchong 637000, Sichuan, China.
Am J Transl Res. 2025 Aug 15;17(8):6080-6091. doi: 10.62347/DMXL9003. eCollection 2025.
To investigate the effects of preoperative oral carbohydrate administration on insulin resistance and recovery quality in patients undergoing selective laparoscopic liver resection.
Data from 110 patients were retrospectively analyzed, and divided into a control group (n=55) and a research group (n=55). The control group received 800 mL of distilled water at 20:00 the evening before surgery, and 400 mL 2.5 hours before surgery. The research group received the same volume of carbohydrates at the same time points. Differences in blood glucose, insulin levels, insulin resistance (HOMA-IR), recovery quality (QoR-15), inflammatory and immune cell markers, and liver function were compared. Spearman correlation and logistic regression analyses were performed to explore the relationship between carbohydrate intake and recovery.
The research group had significantly lower incidence and severity of nausea and vomiting compared to the control group (χ=0.037, χ=0.030, both P<0.05). Postoperative recovery times, including post-anesthesia care, first rectal exhaust, and first feeding, were shorter in the research group (t=0.034, 0.021, 2.832, all P<0.05). Insulin levels and HOMA-IR were lower on postoperative days 1 and 3 in the research group (both P<0.05). QoR-15 scores were higher in the research group (F=100.100, P<0.001), showing an increasing trend over time (F=22.130, P<0.001). On day 3, inflammatory and liver function markers were lower in the research group, while immune cell markers were elevated (all P<0.05). Preoperative carbohydrate intake correlated with improved insulin sensitivity and recovery quality (P<0.05).
Preoperative oral carbohydrate administration reduces insulin resistance, enhances recovery, and improves postoperative rehabilitation quality in patients undergoing elective laparoscopic liver resection.
探讨术前口服碳水化合物对择期腹腔镜肝切除术患者胰岛素抵抗及恢复质量的影响。
回顾性分析110例患者的数据，将其分为对照组（n = 55）和研究组（n = 55）。对照组在手术前晚20:00口服800 mL蒸馏水，术前2.5小时口服400 mL。研究组在相同时间点摄入相同体积的碳水化合物。比较两组患者血糖、胰岛素水平、胰岛素抵抗（HOMA-IR）、恢复质量（QoR-15）、炎症和免疫细胞标志物以及肝功能的差异。进行Spearman相关性分析和逻辑回归分析，以探讨碳水化合物摄入与恢复之间的关系。
研究组恶心呕吐的发生率和严重程度均显著低于对照组（χ = 0.037，χ = 0.030，P均<0.05）。研究组术后恢复时间，包括麻醉后护理、首次肛门排气和首次进食时间均较短（t = 0.034，0.021，2.832，P均<0.05）。研究组术后第1天和第3天的胰岛素水平和HOMA-IR较低（P均<0.05）。研究组的QoR-15评分较高（F = 100.100，P<0.001），且随时间呈上升趋势（F = 22.130，P<0.001）。术后第3天，研究组的炎症和肝功能标志物较低，而免疫细胞标志物升高（P均<0.05）。术前碳水化合物摄入与胰岛素敏感性提高和恢复质量改善相关（P<0.05）。
术前口服碳水化合物可降低择期腹腔镜肝切除术患者的胰岛素抵抗，促进恢复，提高术后康复质量。
