کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2687139 1142995 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The effect of perioperative glucose control on postoperative insulin resistance
ترجمه فارسی عنوان
تاثير کنترل قند خون بر مقاومت به انسولين بعد از عمل
کلمات کلیدی
رزکسیون کبد؛ جراحی شکم؛ کورتیزول؛ هورمون‌های استرس، دفع کل گلوکز،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی مراقبت های ویژه و مراقبتهای ویژه پزشکی
چکیده انگلیسی

SummaryBackground & aimsPostoperative insulin resistance and the consequent hyperglycemia affects clinical outcome. Insulin sensitivity may be modulated by preoperative nutrition, adequate pain management and minimal invasive surgery. This study aims to disclose the impact of perioperative glucose control on postoperative insulin resistance.MethodsTwenty patients scheduled for elective open hepatectomy were enrolled in this prospective, randomized study. In the treatment group (n = 9) insulin was administered intravenously to keep blood glucose between 6 and 8 mmol/l during surgery. The control group (n = 8) received insulin if blood glucose >14 mmol/l. Insulin sensitivity was measured by a hyperinsulinemic normoglycemic clamp (0.8 mU/kg/min), performed on all patients both on the day before surgery and immediately postoperatively. Plasma cortisol, insulin and C-peptide were measured.ResultsThere was a significant difference in mean glucose value during surgery. In the control group 8.8 mmol/l (SD 1.5) vs. 6.9 mmol/l (SD 0.4) in the treated group, p = 0.003. In the control group insulin sensitivity decreased to 21.9% ± 16.2% of the preoperative value and in the insulin treated group to 46.8 ± 15.5%, p < 0.005. Insulin levels were significantly higher in the treatment group as well as consequently lower C-peptide levels.ConclusionsThis trial revealed a significant difference in postoperative insulin resistance in the group treated with insulin during surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Nutrition - Volume 31, Issue 5, October 2012, Pages 676–681
نویسندگان
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