体外循环术后血糖与预后  

Blood glucose and prognosis after cardiopulmonary bypass

作　　者：谭今[1] 白连松[1] 张仁宇[1] 杨帆[1] 杨建[1] 

机构地区：[1]四川大学附属华西医院心血管外科,成都610041

出　　处：《重庆医科大学学报》2009年第10期1418-1420,共3页Journal of Chongqing Medical University

摘　　要：目的:探讨成人体外循环术后血糖与预后的关系。方法:选取我院2008年6月至2008年12月之间连续408例18岁以上的体外循环手术患者,测定其术后48 h内的血糖值,并收集相关临床资料。结果:根据术后最高血糖,将病人分为正常组(<11.1 mmol/L)308例(75.49%)和升高组(≥11.1 mmol/L)100例(24.51%)。2组病人分别死亡1、12例,死亡率为0.32%、12%,P<0.01,RR值37.5,95%CI(1.59～5.65),有统计学意义;发生并发症分别为19、63例,发生率为6.17%、63%,P<0.01,RR值10.21,95%C(I1.86～2.78),有统计学意义。虽然术中血糖、转流时间等也与预后相关,但经logistic多因素回归分析得出术后血糖不仅较其它因素能更准确的预测并发症(系数为0.684,P<0.01),而且是与预后相关的独立危险因素(回归系数为-0.390,P<0.01)。结论:体外循环手术后早期的最高血糖值可以反应疾病的预后。血糖越高,并发症和死亡率越高。Objective： To explore the relationship between the blood glucose and its prognosis after CPB operation.Methods： 408 consecutive adult patients underwent CPB surgery from June 2008 to December 2008 were enrolled to the study.The blood glucose was measured over the first 48 hours postoperatively.Any other clinical datum were also collected.Results： The highest blood glucose level was used to classify patients for 2 groups.The normal group（〈11.1 mmol/L） had 308 patients（75.49%） and the abnormal group（≥11.1 mmol/L） had 100 patients （24.51%）. The in-hospital mortality of these 2 groups were 0.32%（1/308） and 12% （12/100）, P〈0.O1, RR=37.5, 95 % CI （ 1.59 - 5.65 ）. The incidence of complications were 6.17% （ 19/308 ） and 63 % （ 63/100 ）, P〈0.01, RR= 10.21, 95%CI （1.86 -2.78）.There was statistically significant difference between the 2 groups. Although the intraoperative blood glucose and bypass time were associated with prognosis, postoperative blood glucose can not only predict complications more accurately （regression coefficient=0.684, P〈0.01 ）, hut also be an independent risk factor for prognosis （regression coefficient=-0.390,P〈0.01 ）, which was verified by multivariate logistic regression analysis. Corte, lusion： The blood glucose in the early postoperation was associated with the prognosis. The higher the blood glucose was, the worse the consequence.

关 键 词：体外循环 血糖 预后 

分 类 号：R654.1[医药卫生—外科学]