混合糖电解质注射液对肺癌病人术后血糖、胰岛素和C肽的影响观察

目的:比较混合糖电解质注射液和葡萄糖注射液对肺癌病人术后血糖、胰岛素和C肽的影响及安全性。方法:前瞻性单盲随机对照研究。选取肺癌病人临床有效病例60例,于术后第2天静脉滴注混合糖电解质注射液(治疗组)或10%葡萄糖注射液(对照组),1 500ml/d,3小时内输注完,连用3d。观察病人用药前和用药中血糖、胰岛素和C肽的变化情况,比较两组之间的差别。同时观察用药前后血尿酸、尿素氮、肝肾功能、心电图等变化以及不良反应的发生情况。结果:两组输液后即刻与第5天的血糖浓度均稍高于输液前,但治疗组前后血糖水平比较,差异无统计学意义(P>0.05),且输液后即刻血糖水平明显低于对照组(P<0.05),对照组输液前后血糖升高,差异有显著意义(P<0.05)。治疗组用药中对血胰岛素和C肽影响亦较小,对照组该指标明显升高,组间比较差异有统计学意义(P<0.05)。用药后两组病人均未发现血尿酸、尿素升高,肝肾功能和心电图等指标无明显异常变化,未出现不良反应。结论:适量静脉输注混合糖电解质注射液对肺癌病人术后血糖和胰岛素的影响较小,有较好的安全性。

Effects of Carbohydrate-electrolyte Solution on Serum Glucose and Peptide C and Insulin Levels and Its Safety in Postoperative Patients with Lung Cancer

Objective:To compare carbohydrate-electrolyte solution with glucose injection in the effectiveness and safety in stabilization of serum glucose and peptide C and insulin levels in lung cancer surgical patients.Methods:A survey on 60 patients subject to lung cancer surgical patients was carried out by a randomized single blind parallel controlled prospective study.The patients in study group were administered with 1 500ml/day 10%fructose injection in travenously in 3 h in a series of 3 days since the right-day of operation.While 10%glucose injection was administered incontrol group.The changes of serum glucose and peptide C and insulin levels before and during injection,uric acid,uric nitrogen,liver and renal functions,ECG and adverse events were observed.Results:The immediate blood glucose levels and them of the 5th day after infusion were slightly higher than before infusion for the two groups,but the blood glucose levels after the treatment compared with before the treatment,and their difference was not statistically significant(P>0.05) in the treatment,while the immediate blood glucose levels of the treatment group after infusion was significantly lower than the control group(P<0.05).Additionally,the blood glucose levels before and after infusion increased significantly,and their different was significant(P<0.05) in the control group.On the other hand,serum insulin and C-peptide was effected mildly by the drugs in the treatment group,whereas they increased obviously in the control group.As a result,the difference between the two groups was statistically significant(P<0.05).Conclusion:Adequate intravenous injection of carbohydrate-electrolyte solution is safe and has relatively mild effects on serum glucose and peptide C and insulin levels.