The effects of different degrees of surgical trauma on insulin resistance in perioperative patients
MEI Qi
MA Xiang-ming
FU Qing-jiang
CAO Li-ying
Abstract：Objective To observe the effects of different degrees of surgical trauma on insulin resistance (IR)in perioperative patients and to understand the relationship between perioperative IR and the degrees of surgi -cal trauma.Methods Totally 100 patients with hepatobiliary and pancreatic surgeries were enrolled from Mar. 2016 to Dec.2016 in Kailuan General Hospital of Tangshan,Raoyang Hospital and Zhangbei Hospital including 30 liver surgeries,38 gallbladder surgeries,and 32 pancreatic surgeries.The 100 patients were divided into mild trauma group(n=36),moderate trauma group(n=33),and severe trauma group(n=31)according to the degrees of surgi-cal trauma score(OSS).Fasting plasma glucose(FPG)and fasting plasma insulin(FINS)were detected before anesthesia(T0),tracheal extubation after operation(T1),the first fasting(T2)day and the third fasting day after operation(T3),respectively.The IR index was calculated by homeostasis model assessment(HOMA-IR)and in-sulin sensitivity index(ISI)was calculated by quantitative insulin sensitivity test index(QUICKI).The different time interval △ISI was calculated.Results The levels of FPG,FINS,IR index and ISI in the three groups in T 1, T2and T3were statistically significant(P<0.05),and the FPG,FINS levels and IR index were highest and ISI were lowest in severe trauma group.The levels of FPG,FINS,IR index,ISI in T0,T1,T2and T3in the same group were statistically significant(P<0.05),and the FPG,FINS and IR index were highest and ISI was lowest in T 2.The△ISI in three groups at the same time was statistically significantly different(P<0.05),and was highest in the se-vere trauma group.The △ISI in the same group at different times was statistically significantly different(P <0.05),and △ISI2was highest.Pearson correlation analysis showed that IR index in perioperative period was posi -tively correlated with OSS(r=0.938,P<0.001).Conclusion Different degrees of surgical trauma patients have different levels of FPG,FINS,IR index and ISI changes at different times,which are most significant on the first day after surgeries.IR appears earlier and increases with the degrees of surgical trauma,and gradually decreases with the time of patients'recovery.IR is closely related to the degrees of surgical trauma.
Keywords：traumaperioperative periodinsulin resistanceindex
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 280-283 )