探讨术前麦芽糊精果糖液对胃癌患者胰岛素抵抗、菌群多样性及肠道功能的影响。 方法 选取河北北方学院 附属第一医院 2021 年 5 月至 2022 年 4 月期间 100 例需要手术治疗的胃癌患者。 应用随机数字表法将其分为对照组与试验 组,每组 50 例,对照组常规术前禁食 8~ 12 h,禁饮 2 h,试验组采用加速康复外科(ERAS)理念的术前干预(术前 10 h 服用麦 芽糊精果糖液,手术麻醉前 2 h 给予麦芽糊精果糖液)。 比较两组术后 1 周手术资料、血糖相关指标、肠道菌群多样性及肠道 功能、并发症发生率。 结果 术后 1 周,试验组空腹胰岛素浓度、胰岛素抵抗指数值均低于对照组,胰岛素敏感指数高于对照 组(t = 9. 017,t = 33. 522,t = 3. 216;P<0. 01,P<0. 01,P= 0. 002);术后 1 周,试验组 Chao1 指数和 Shannon 指数均大于对照组,首 次排气时间及首次排便时间均短于对照组(t = 2. 720,t = 6. 540,t = 3. 344,t = 3. 578;P= 0. 008,P<0. 01,P = 0. 001,P = 0. 001),两 组患者手术资料(手术时间、手术出血、手术方式等)比较,差异无统计学意义(P>0. 05)。 结论 术前麦芽糊精果糖液可有效改 善术后血糖水平及肠道菌群多样性,进而提高肠道功能,且不会增加并发症发生率。

To investigate the effect of preoperative maltodextrin fructose solution on the diversity of gastric microflora and intestinal function. Method Select 100 gastric cancer patients requiring surgical treatment in our hospital from May 2021 to April 2022. They were divided into control group and experimental group by random number table method 50 cases in each group. The control group routinely fasted for 8 - 12 hours before surgery and fasted for 2 hours. The experimental group adopted the preoperative intervention of enhanced recovery after surgery ERAS concept maltodextrin fructose solution was administered 10 hours before surgery and maltodextrin fructose solution was administered 2 hours before surgical anesthesia . The general data blood glucoserelated indicators intestinal flora diversity intestinal function and complication rates were compared between the two groups. Result One week after operation the fasting insulin concentration and insulin resistance index of the experimental group were lower than those of the control group and the insulin sensitivity index was higher than that of the control group t = 9. 017 33. 522 3. 216 P<0. 01 < 0. 01 0. 002 One week after operation the Chao1 index and Shannon index of the experimental group were higher than those of the control group and the time to the first exhaust and the time to the first defecation were shorter than those in the control group t = 2. 720 6. 540 3. 344 3. 578 P= 0. 008 <0. 01 0. 001 0. 001 . There was no significant difference in surgical data operation time surgical bleeding surgical method etc. between the two groups P> 0. 05 . Conclusion Preoperative maltodextrin fructose solution can effectively improve postoperative blood glucose level and intestinal flora diversity thereby improving intestinal function without increasing the incidence of complications.