Zhongguo linchuang yanjiu (Jun 2023)
Impacts of preoperative oral glucose 10% based on ERAS concept on postoperative InsRβ protein and insulin resistance in patients with gastric cancer
Abstract
Objective To analyze the effects of preoperative oral 10% glucose based on enhanced recovery after surgery (ERAS) concept on insulin receptor β-subunit (InsRβ) protein level and insulin resistance in postoperative gastric cancer patients. Methods Eighty patients with gastric cancer undergoing surgical treatment in Xianning Central Hospital from March 2020 to March 2022 were randomly divided into routine group and ERAS group according to perioperative treatment (n=40, each) . The routine group patients were treated with conventional perioperative treatment, while the ERAS group patients were treated with the concept of ERAS (including oral administration of 500 mL of 10% glucose solution 2 hours before surgery) . The surgical related indicators, InsRβ, blood glucose, C-reactive protein (CRP) , insulin, homeostasis model assessment insulin resistance index (HOMA-IR) , complications and patients' satisfaction were compared between two groups. Results There was no significant difference in operation time and intra-operative bleeding between two groups (P＞0.05) . The first exhaust time, the fluid intake time and postoperative hospital stay in ERAS group significantly shortened compared with those in routine group (P＜0.01) . At 1 and 3 days after surgery, InsRβ protein level decreased in both groups and was statistically higher in ERAS group than that in routine group (P＜0.05) . The levels of blood glucose, CRP, insulin and HOMA-IR increased in two groups and were significantly lower in ERAS group than those in routine group (P＜0.05) . Compared with postoperative 1 and 3 days, the expression of InsRβ protein increased in both groups of patients 7 days after surgery and was higher in ERAS group than that in routine group (P＜0.05) , and the levels of blood glucose, CRP, insulin and HOMA-IR decreased in two groups and were lower in ERAS group than those in routine group (P＜0.05) . Compared with routine group, the incidence of complications in ERAS group was slightly lower without significant difference (2.50% vs 12.50%, χ2=2.882, P=0.089) , and postoperative satisfaction was slightly higher without significant difference (97.50% vs 85.00%, χ2=2.505, P=0.114) . Conclusion Preoperative oral administration of 10% glucose based on ERAS concept can effectively alleviate postoperative insulin resistance, improve InsRβ protein level and reduce postoperative hospital stay, which are conductive to the postoperative rehabilitation of the patients with the gastric cancer.
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