Abstract:

Objective　To investigate the effects of oral high-glucose solution before laparoscopy on postoperative gastrointestinal function, inflammation response, and insulin resistance in patients with colorectal cancer. Methods　A total of 78 patients with colorectal cancer admitted to Lianyungang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from May 2020 to July 2022 were selected as the study objects. They were divided into 2 groups by the random number table method: an observation group (39 cases) and a control group (39 cases). In the observation group, there were 20 males and 19 females, aged 38-75 (56.65±8.43) years, Dukes stage: 21 cases of stage Ⅰ and 18 cases of stage Ⅱ. In the control group, there were 19 males and 20 females, aged 39-74 (55.79±8.39) years, Dukes stage: 22 cases of stage Ⅰ and 17 cases of stage Ⅱ. The control group received conventional treatment, and the observation group received oral high-glucose solution. Postoperative gastrointestinal function, inflammatory response, insulin resistance index, and complications were compared between the two groups. Independent sample t test, paired t test, and χ² test were used. Results　After treatment, the postoperative anal exhaust time, the first postoperative defecation time, and the hospital stay in the observation group were (23.97±2.85) h, (14.35±5.43) h, and (5.69±0.87) d, respectively, which were shorter than those in the control group [(34.68±3.94) h, (21.06±7.47) h, and (9.52±1.14) d], with statistically significant differences (all P<0.05). After treatment, the levels of tumor necrosis factor α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) in the observation group were (141.85±30.29) ng/L, (8.69±2.05) mg/L, and (7.34±0.93) ng/L, respectively, which were lower than those in the control group [(182.46±33.37) ng/L, (15.33±2.78) mg/L, and (9.97±1.54) ng/L], with statistically significant differences (all P<0.05). After treatment, the insulin resistance index of the observation group was lower than that of the control group [(5.14±0.31) vs. (7.75±0.96)], with a statistically significant difference (P<0.05). After treatment, the total incidence of complications in the observation group was 10.25% (4/39), which was lower than that in the control group [28.21% (11/39)], with a statistically significant difference (P<0.05). Conclusion　The oral administration of high-glucose solution before laparoscopy can effectively improve the postoperative gastrointestinal function in patients with colorectal cancer, reduce the level of inflammation, improve their insulin resistance, and reduce the incidence of complications, which is worthy of promotion.

Key words:

Colorectal cancer, Laparoscopy, High-glucose solution, Gastrointestinal function, Inflammation level, Insulin resistance index,  , Complications

摘要：

目的　探讨结直肠癌患者腹腔镜术前口服高糖溶液对术后胃肠功能、炎症水平及胰岛素抵抗的影响。方法　选择2020年5月至2022年7月南京中医药大学附属连云港市中医院收治的78例结直肠癌患者为研究对象，利用随机数字表法将其分为两组，观察组39例，对照组39例。观察组男20例、女19例，年龄38～75（56.65±8.43）岁，Dukes分期：Ⅰ期21例，Ⅱ期18例；对照组男19例、女20例，年龄39～74（55.79±8.39）岁，Dukes分期：Ⅰ期22例，Ⅱ期17例。对照组采用常规治疗，观察组术前采用高糖溶液口服。比较两组患者的术后胃肠功能、炎症水平、胰岛素抵抗指数及并发症情况。采用独立样本t检验、配对t检验和χ²检验。结果　治疗后，观察组术后肛门排气时间、术后首次排便时间、住院时间分别为（23.97±2.85）h、（14.35±5.43）h、（5.69±0.87）d，均短于对照组（34.68±3.94）h、（21.06±7.47）h、（9.52±1.14）d，差异均有统计学意义（均P<0.05）；治疗后，观察组患者肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平分别是（141.85±30.29）ng/L、（8.69±2.05）mg/L、（7.34±0.93）ng/L，均低于对照组（182.46±33.37）ng/L、（15.33±2.78）mg/L、（9.97±1.54）ng/L，差异均有统计学意义（均P<0.05）；治疗后，观察组胰岛素抵抗指数（5.14±0.31），低于对照组（7.75±0.96），差异有统计学意义（P<0.05）；治疗后，观察组并发症总发生率为10.25%（4/39），低于对照组的28.21%（11/39），差异有统计学意义（P<0.05）。结论　腹腔镜术前口服高糖溶液能有效改善结直肠癌患者术后的胃肠功能，降低患者炎症水平，改善患者胰岛素抵抗，降低并发症发生率，值得推广。

关键词:

结直肠癌, 腹腔镜手术, 高糖溶液, 胃肠功能, 炎症水平, 胰岛素抵抗指数, 并发症