丙泊酚和七氟醚对2型糖尿病胃癌患者麻醉中血糖和胰岛素的影响

朱伟波 范振强

[摘要] 目的 分析丙泊酚与七氟醚对2型糖尿病胃癌患者麻醉中血糖及胰岛素水平的影响。方法 以随机平行对照法为分组原则，对该院2018年8月—2019年8月接收的84例2型糖尿病胃癌患者展开分组研究：七氟醚组（予以七氟醚麻醉，42例）、丙泊酚组（予以丙泊酚麻醉，42例）。对两组麻醉前、麻醉中的血糖及胰岛素水平进行对比。 结果 麻醉后，两组血糖水平均有所上升，胰岛素水平则下降;但丙泊酚组麻醉后5 min、2 h的血糖水平仍低于七氟醚组;而胰岛素水平则均较七氟醚组高（P<0.05）。 结论 麻醉药物均会对2型糖尿病胃癌患者的血糖、胰岛素造成一定影响，但相较于七氟醚，丙泊酚对患者血糖及胰岛素的影响较小，因而更适用于2型糖尿病胃癌手术麻醉中。

[关键词] 2型糖尿病;胃癌;血糖及胰岛素;丙泊酚;七氟醚

[中图分类号] R587.1; R614;R735.2          [文献标识码] A          [文章编号] 1672-4062（2020）05（b）-0052-03

Effects of Propofol and Sevoflurane on Blood Glucose and Insulin During Anesthesia in Patients with Type 2 Diabetic Gastric Cancer

ZHU Wei-bo， FAN Zhen-qiang

Department of Anesthesiology， Binzhou People's Hospital， Binzhou， Shandong Province， 256600 China

[Abstract] Objective To analyze the effects of propofol and sevoflurane on blood glucose and insulin levels in patients with type 2 diabetes and gastric cancer during anesthesia. Methods Using the randomized parallel control method as the grouping principle， a group study was performed on 84 patients with type 2 diabetic gastric cancer received in the hospital from August 2018 to August 2019： the sevoflurane group （with sevoflurane anesthesia， 42 cases）， Propofol group （propofol anesthesia， 42 cases）. The blood glucose and insulin levels before and during anesthesia were compared between the two groups. Results After anesthesia， the blood glucose level of the two groups increased and the insulin level decreased; however， the blood glucose levels of the propofol group at 5 minutes and 2 hours after the anesthesia were still lower than those of the sevoflurane group; and the insulin levels were higher than those of the sevoflurane group（P<0.05）. Conclusion Anesthetic drugs can affect blood glucose and insulin in patients with type 2 diabetes and gastric cancer. However， compared with sevoflurane， propofol has less effect on patients' blood glucose and insulin， so it is more suitable for surgical anesthesia of type 2 diabetes gastric cancer.

[Key words] Type 2 diabetes; Gastric cancer; Blood glucose and insulin; Propofol; Sevoflurane

2型糖尿病屬于临床高发慢性疾病之一，高发于35岁以后人群，以持续高血糖为主要特征，患病者往往存在疲乏无力、消瘦等症状;此外，血糖持续升高的患者极易诱发胃癌，胃癌属于机体消化系统的恶性肿瘤之一，老年人较多见。上述疾病合并后的治疗手段多以手术为主，效果良好，但手术操作及术中麻醉均会使患者产生应激反应，同时抑制全身多个系统，降低治疗效果[1]。因此，临床有必要为2型糖尿病胃癌患者选用一种既高效又安全的麻醉药物，以减轻其术中应激反应，减少麻醉药物对血糖及胰岛素的影响。基于此，对该院于2018年8月—2019年8月收治的84例2型糖尿病胃癌患者进行了分组研究，目的是探析丙泊酚、七氟醚对上述患者麻醉时的血糖、胰岛素水平影响，报道如下。

1  资料与方法

1.1  一般资料