Mức Đường Huyết và Bài Tiết Insulin Trong Tình Trạng Tăng Đường Huyết Do Phẫu Thuật Ở Bệnh Nhân Béo Phì Có Đường Huyết Bình Thường

Springer Science and Business Media LLC - Tập 18 - Trang 1460-1466 - 2008
Marina Michalaki1, Venetsana Kyriazopoulou1, Panagiotis Mylonas1, Maria-Ioanna Argentou2, Yves Debaveye3, Fotis Kalfarentzos2, Apostolos G. Vagenakis1
1Department of Medicine, Division of Endocrinology, University Hospital of Patras, Patras, Greece
2Department of Surgery, Nutrition Support and Morbid Obesity Unit, University Hospital of Patras, Patras, Greece
3Department of Intensive Care Medicine, University of Leuven, Leuven, Belgium

Tóm tắt

Tăng đường huyết tạm thời thường được quan sát thấy ở những người không bị tiểu đường trong quá trình phẫu thuật. Chúng tôi tiến hành nghiên cứu này để điều tra (1) kiểu bài tiết insulin và mức độ glucose trong quá trình phẫu thuật chọn lọc, và (2) vai trò của việc nhịn ăn trước phẫu thuật trong sự phát triển của tình trạng tăng đường huyết do phẫu thuật. Chúng tôi đã kiểm tra 21 bệnh nhân béo phì nghiêm trọng có khả năng dung nạp glucose bình thường, những người đã trải qua phẫu thuật giảm béo. Trong số 21 bệnh nhân phẫu thuật, 14 người giữ nguyên trong trạng thái nhịn ăn trong khi bảy bệnh nhân được cho 75 g glucose vào đêm trước phẫu thuật. Họ đã lấy mẫu tại thời điểm cơ sở và từ lúc bắt đầu phẫu thuật một cách thường xuyên trong 9 giờ sau đó, để đo insulin huyết thanh và glucose. Tăng đường huyết xuất hiện trong vòng 1 giờ từ khi bắt đầu phẫu thuật và kéo dài trong 9 giờ. Việc cho 75 g glucose vào đêm trước phẫu thuật đã ngăn ngừa tình trạng tăng đường huyết do phẫu thuật. Hồ sơ insulin được phân tích bằng phân tích tách biến thể tương tự như nhau giữa các bệnh nhân nhịn ăn và những người nhận 75 g glucose. Insulin huyết thanh bị ức chế ở giai đoạn đầu của phẫu thuật và đạt mức cơ sở sau 4 giờ. Tình trạng tăng đường huyết xuất hiện trong vòng 1 giờ từ khi bắt đầu phẫu thuật và kéo dài ít nhất 9 giờ trong khi mức insulin bị ức chế hoặc không thay đổi so với mức cơ sở trong tình trạng bình thường. Việc cho 75 g glucose vào đêm trước phẫu thuật ngăn ngừa tình trạng tăng đường huyết do phẫu thuật mà không làm thay đổi hồ sơ bài tiết insulin.

Từ khóa

#tăng đường huyết #phẫu thuật #insulin #bệnh nhân béo phì #nhịn ăn trước phẫu thuật

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