糖尿病患者术前血糖水平对术后并发症的影响  

Effect of perioperative blood glucose level on postoperational complications in patients with diabetes mellitus

作　　者：黄静[1] 许其稳 

机构地区：[1]武警湖南总队医院,湖南长沙410006

出　　处：《武警医学院学报》2009年第4期323-325,共3页Acta Academiae Medicinae CPAPF

摘　　要：【目的】了解糖尿病患者围手术期血糖水平对术后并发症的影响。【方法】根据美国ADA空腹血糖(FPG)标准,将222例糖尿病患者分为3组,A组116例,术前FPG≤6.9 mmol/L;B组88例,术前FPG≤9.0mmol/L;C组18例,为急诊手术组;然而分析3组患者术前血糖水平与术后FPG、2HPG、尿酮体、低血糖、心律失常、抗炎时间及伤口愈合天数的变化。【结果】术后酮症:A组2例(1.72%);B组8例(9.10%);C组8例(88.88%);术后低血糖反应:A组4例(4.55%);B组6例(5.17%);C组2例(22.22%);术后心律失常:A组8例(6.90%);B组5例(11.36%);C组8例(88.88%)。其中B组和C组各有2例伤口不愈合,A组抗生素治疗天数也较B组与C组缩短。由此可见,A组患者因术前FPG及2HPG控制较满意,故术后并发症与B组和C组比较有显著性差异。【结论】对于糖尿病患者加强术前血糖控制,使FPG<7 mmol/L,2HPG<9 mmol/L以下,是保证手术效果和防止术后并发症的关键。[ Objective] To evaluate the effect of perioperative blood glucose level on postoperational complications in patients with diabetes mellitus. [Methods] A total of 222 cases of patients diagnosed according to American ADA FPG criteria as diabetes mellius were divided into 3 groups： group A （126 cases）, perioperative FPG≤6.9 mmol/L; group B （88 cases）, perioperative FPG≤9.0 mmol/L; group C （18 eases）, emergency operation group.The perioperative FPG and postoperational FPG, 2HPG, ketone, hypoglycemia, arrythrnia, antibiotics administrated, and wound healing were analysed in patients of the three groups. [Results] Postoperafional ketoacidosis occurred in 2 cases in group A （1.72%）; 8 eases in group B （9.10%）; and 8 cases in group C （88.88%） .Postoperational hypoglycemia occurred in4 cases in group A （4.55%）, 6 cases in group B （5.17%） and2 cases in group C （22.22%） .Postoperational arrythmia occurred in 8 cases in group A （6.90%） 5 cases in group B （11.36%） and 8 cases in group C （88.88%）. Wound unhealing occurred in 2 cases in group B and C respectively.Antibiotics administration course was shorter in group A than in group B or C. So, better control of perioperative FPG and 2HPG in patients of group A leaded to less postoperational complications. [ Conclusion ] For patients with diabetes mellitus, ideal control of perioperative blood glucose （FPG 〈 7mmol/L, 2HPG 〈 9mmol/L） is critical to get operative efficacy and prevent postoperational complications.

关 键 词：糖尿病 围手术期血糖 并发症 

分 类 号：R587.1[医药卫生—内分泌]