关键词: 术前口服碳水化合物, 肝癌, 安全性, 临床疗效

Abstract: 【Abstract】〓Objective〓To investigate the safety of preoperative oral carbohydrate loading and the effect on postoperative stress hyperglycemia as well as insulin resistance after elective liver cancer. Methods〓Sixty-one cases with liver cancer undergoing elective liver surgery were randomized into experimental group and control group. The patients in the experimental group were given 10% glucose 250 ml oral drink three hours before operation, while the ones in the control group were fasted overnight. The volume of gastric juices and perioperative blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) were recorded and analyzed. Results〓None was found to have aspiration. The average gastric juice of experimental group and control group was 45.4±18.4 ml and 38.8±17.2 ml and no statistical difference was found between two groups. There were no significant difference between two groups in preoperative general information, liver function, blood glucose, insulin and HOMA-IR level (P>0.05). The liver function in the postoperative 5 days were similar between two groups, and the level of AST, ALT and total serum bilirubin were significantly lower in the experimental group in the postoperative 1 and 3 days (P<0.05). Moreover, the levels of fasting blood glucose, insulin, HOMA-IR in the experimental group were statistically lower in the postoperative 1, 3 and 5 days (P<0.05). Conclusion〓Ten percent glucose of 250 ml oral administration in 3 hours before operation was safe and it can significantly reduced postoperative stress hyperglycemia and insulin resistance.

Key words: Preoperative oral carbohydrate loading, Liver cancer, Safety, Clinical effect.