Effects of preoperative oral carbohydrate on postoperative insulin resistance in radical gastrectomy patients

摘要: OBJECTIVE To investigate the effects and mechanism of postoperative insulin resistance in gastrectomy patients with preoperative oral carbohydrate. METHODS From April to October 2011, 60 consecutive gastric cancer met inclusion criteria were divided into carbohydrate group placebo by randomized double-blind principles. Resting energy expenditure (REE), fasting blood glucose, triglyceride level detected 4 hours preoperatively. The 500 ml or administrated orally 2-3 before anaesthesia. Two underwent radical distal subtotal under epidural compounded intravenous anesthesia. After laparotomy abdomen was closed, a piece rectus abdominis taken fixed 3% glutaraldehyde. REE, immediately after surgery. changes index, triglycerides level, REE respiratory quotient compared pre- post-operatively. mitochondrial ultrastructure observed transmission electron microscopy respectively. RESULTS There 48 (34 males 14 females) completed trial. 24 groups In group, post-operative quotient, serum damage index 12.68 ± 3.13, (1458 169) kcal/d, 0.73 0.42, (0.53 0.24) g/L 1.14 0.33, And above items 5.67 1.40, (1341 110) 0.79 0.22, (1.04 0.97) 0.92 0.19 All difference statistically significant (t = 6.646, 2.851, 6.546, 2.542 2.730, all P < 0.05). Oral showed markedly swollen mitochondria, steep membrane not clear, mitochondria appeared vacuolated changes. CONCLUSIONS Preoperative could reduce improve material metabolism status patients. possible mechanisms should be related promotion release protection function.