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术前补液对连台胃肿瘤腔镜手术患者应激反应影响的研究

陈哲颖 胡文娟 黄一乐 金洁   

  1. 上海交通大学医学院附属仁济医院手术室
  • 出版日期:2016-12-25 发布日期:2016-12-25
  • 基金资助:
    上海交通大学医学院科技基金项目(Jyh1303)

The effect of preoperative rehydration on stress response in gastric tumor patients during continuous endoscopy surgery

  • Online:2016-12-25 Published:2016-12-25

摘要: 目的:分析术前静脉补5% 葡萄糖盐水(GNS)1000mL,对全麻下行连台胃肿瘤腔镜手术患者应激反应和术后应激性高血糖的影响。方法:将122 例全麻下行连台胃肿瘤腔镜手术患者为研究对象,随机分为补液干预组和常规组。补液干预组:对连台手术患者禁食禁饮达到12h 时的患者,静脉输入5%GNS 1000mL,输液完毕穿刺套管针勿拔,带入手术室。常规组:对连台手术患者术前静脉未输入任何液体。比较两组手术患者术前口渴和饥饿的程度、平均动脉压、心率、血糖。结果:两组手术患者术前口渴、饥饿的程度差异有统计学意义(P <0.001)。常规组麻醉前平均动脉压、心率与补液干预组比较,差异有统计学意义(P <0.001)。两组手术患者术后24h 血糖均有显著升高,术后24h、术后48h 血糖值组间差异有统计学意义(P <0.05,P <0.001)。结论:术前静脉补5%GNS 1000mL,可减少连台胃肿瘤腔镜手术患者术前口渴、饥饿的程度和手术应激反应,加快术后血糖恢复。

Abstract: Objective: To explore the effect of preoperative intravenous supplement 5% GNS 1000mL on stress response and postoperative stress hyperglycemia in gastric cancer patients with general anesthesia during continuous endoscopy surgery. Methods: Totally 122 gastric cancer patients with general anesthesia during continuous endoscopy surgery were randomLy divided into rehydration intervention group and regular group. Rehydration intervention group: we transfused 5%GNS 1000mL by vein for patients who were forbidden to eat and drink over 12 hours. After the intravenous infusion, the puncture trocar was remained and brought into the operating room. Regular group: we did not transfuse any liquid for patients before the continuous surgery. Then we compared the degree of thirsty and hungry, mean arterial pressure, heart rate and changes in blood sugar before surgery between the two groups. Results: Patients' degree of thirsty and hungry before surgery had significant statistical differences (P<0.001). Patients' mean arterial pressure and heart rate before anesthesia in regular group were significantly different from rehydration intervention group (P<0.001). The blood sugar at 24 hours after surgery had a significant rise in both groups, and the blood sugar at 24 hours and 48 hours after surgery had significant statistical differences (P<0.05) between groups. Conclusion: Preoperative intravenous supplement 5% GNS 1000ML can reduce the degree of thirsty and hungry and surgical stress response in gastric cancer patients with continuous endoscopy surgery, and can speed up the recovery of blood sugar after surgery.