| Objectives:To evaluate the influence of 2 hours before oral administration of 10%glucose solution on gastric cancer patients' subjective comfort,insulin resistance and postoperative rapid rehabilitation.So as to provide reference for preoperative selection of fasting and prohibition for gastric cancer patients.Materials and methods:From June 2017 to March 2018,the 60 patients who underwent gastrectomy for gastric cancer at the Department of Gastrointestinal Surgery,Subei People's Hospital of Yangzhou City were selected as observation objects,and were randomly divided into treatment group(sugar-water group)and control group(dumb-drinking group).In 30 patients,the treatment group received oral administration of 10%glucose solution 500ml 2 hours before surgery(feeding was completed within 15 minutes);the control group fasted for 12 hours before surgery and banned drinking for 8 hours.The perioperative management of the two groups of patients was performed according to the regular rapid rehabilitation surgical procedures of the undergraduate department,and the same group of surgeons performed the surgery.The subjective comfort levels of the two groups were measured 3 hours before surgery and 30minutes before surgery,mainly including thirst and hunger.The patient's operative time,intraoperative blood loss,first discharge time,postoperative hospital stay were recorded;postoperative complications were recorded.We collected peripheral venous blood from 3 patients on the day of surgery,on the first day after surgery,and on the third day after surgery.Blood glucose concentrations and serum insulin concentrations were measured.The insulin resistance index was calculated using a steady-state model.Results:One patient in the treatment group did not receive oral glucose solution as required.One patient was excluded from the study.The remaining 59 subjects were enrolled in the study,29 in the treatment group and 30 in the control group.During the study,there were no intraoperative deaths,no deaths due to complications,and all patients were discharged.1.In the treatment group,there were 29 patients,including 21 male patients and 8 female patients.The patient's age was 64.07 ±6.81 years,and the BMI was 21.98 ± 2.60 kg/m2.In the control group,there were 30 patients,including 21 male patients and 9 female patients.The patient's age was 63.83 ± 7.99 years,and the BMI was 21.92 ± 2.59 kg/m2.There was no difference in gender,age,BMI,etc.between the two groups(P>0.05).2.In the treatment group,the intraoperative blood loss was 75.52 ± 35.92ml and the operation time was 172.59 ± 53,91 minutes.Among them,14 patients underwent total gastrectomy and 15 patients underwent partial gastrectomy.In the control group,the intraoperative blood loss was 87.33 ± 23.92ml and the operation time was 172.59 ± 53.91 minutes.Among them,16 patients underwent total gastrectomy and 14 patients underwent partial gastrectomy.The two groups of patients had no statistical significance in the two groups of data,such as operation time,blood loss,and surgical methods(P>0.05).3.The hunger sensation scores in the treatment group and the control group were 3.21 ±0.89 and 2.75 ± 1.01 respectively for 3 hours before operation,and the thirst scores were 4.78 ± 0.98 and 4.77 ± 0.93 respectively.There was no significant difference between the two groups(P>0.05).The hunger ratings of the two groups were 1.63 ± 0.37 and 3.14 ± 0.92 for 30 minutes before surgery,and the thirst scores were 1.67±0.48 and 5.14±0.91,respectively.There was a statistically significant difference between the two groups(P<0.01).4.The first postoperative decompression in the treatment group and the control group were 3.79 ± 0.73d and 3.73 ± 0.58d,respectively,and the postoperative hospital stay was 10.69 ±1.23d and 10.43 ± 1.19d respectively.There was no significant difference between the two groups(P>0.05).P>0.05);5.There were no statistically significant differences in blood glucose at 3 hours before surgery,blood glucose at day 1 postoperatively,and blood glucose at day 3 postoperatively between the treatment and control groups(P>0.05).The insulin concentrations at 3 hours before surgery were 6.78 ± 3.10 mU/L and 6.50 ± 1.83 mU/L,respectively.There was no significant difference between the two groups(P>0.05).The insulin concentrations on the first postoperative day were 6.37 +2.37 mU/L and 12.54 ± 4.22 mU/L,respectively.The insulin concentrations at the third postoperative day were 5.56 ± 1.86 mU/L and 10.03 ± 2,56 mU/L,respectively.(P<0.01).The insulin resistance index of the two groups was 1.83 ± 0.95 and 1.81 ± 0.56 respectively for 3 hours before operation,which was not statistically significant(P>0.05).The insulin concentrations on the first postoperative day were 1.95 ± 0.83 and 3.68 ± 1.50,respectively,and the insulin concentrations on the third postoperative day were 1.58 ± 0.60 and 2.84 ± 0.96,respectively,with statistical significance(P<0.01).Conclusion:1.Oral administration of 10%glucose water 2h before surgery can reduce thirst and hunger before the patient's anesthesia,improve patient comfort;2.Oral administration of 10%glucose water 2h before surgery significantly reduced the degree of postoperative insulin resistance. |
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