Clinincal Influence Of Perioperative Glucocorticoid Administration On Patients Who Undergoing Gastrectomy

Objectives: To evaluate the clinical influence of Perioperative glucocorticoid administration in adults undergoing gastric resection for gastric carcinoma.Methods: A prospective , randomized and controlled trial was taken.39 gastric carcinoma patients who underwent D2 radical gastrectomy were randomized into two groups: 20 of which is GC group and 19 of which is controlled group . GC group takes intravenous hydrocortisone sodium succinate 2 hours before the operation and 24 hours after the operation, the rest deal with the control group ,both of the groups take early enteral nutrition support. serum albumin, pre-albumin protein, total protein, blood glucose, sodium, ALT, AST, BUN, CCR, the incidence of complications was compared between two groups. Meanwhile, the levels of serum IL-1(interleukin-1), IL-6(interleukin-6),TNF-α(tumor necrosis factor-α), CRP (C response protein) were measured the day before surgery, 24 hours, 72 hours after surgery.Results: compared with the control group, the serum albumin of GC group improved obviously seven days after the operation. Compared with the day before the operation, the pre-albumin protein of the two groups are significantly decreased seven days and one day after the operation. The above indicators are statistically different between the two groups. There is no significant difference of blood sugar in the two group, no sodium retention, no obvious change in liver and kidney function. The incidence of postoperative complications in GC group did not increase .The IL-1, IL-6, TNF-α, CRP of GC group are significantly lower than those in the control group 24 hours and 72 hours after the surgery.Conclusions: Perioperative glucocorticoid administration in adults undergoing gastric resection for gastric carcinoma can improve the serum albumin and the nutritional situation of patients , and relieve perioperative stress response of gastric surgery .