血糖水平对成人体外膜肺氧合支持患者预后的影响  

Effect of hyperglycemia on clinical outcome in adult patients receiving extracorporeal membrane oxygenation

作　　者：楼松[1] 龙村[1] 李景文[1] 黑飞龙[1] 于坤[1] 王仕刚[1] 胡盛寿[2] 许建屏[2] 常谦[2] 刘平[3] 张海涛[3] 孙寒松[2] 王巍[2] 

机构地区：[1]中国医学科学院,北京协和医学院,阜外心血管病医院体外循环科,北京100037 [2]中国医学科学院,北京协和医学院,阜外心血管病医院心外科,北京100037 [3]中国医学科学院,北京协和医学院,阜外心血管病医院外科恢复室,北京100037

出　　处：《中国体外循环杂志》2010年第1期12-15,49,共5页Chinese Journal of Extracorporeal Circulation

基　　金：高校博士点科研基金(2006-GB04)

摘　　要：目的回顾性总结我院44例成人心脏外科术后患者接受体外膜肺氧合(ECMO)治疗的经验,探索血糖水平对此类患者预后的影响。方法回顾性分析44例成人患者接受ECMO治疗的情况。ECMO治疗期间每3h测量血糖一次,并计算出治疗期间的平均血糖。平均血糖≤8.9mmol/L的患者纳入第一组,其余患者纳入第二组。对比两组患者的死亡率及并发症发生率。结果平均ECMO支持时间为(116±70)h,33例脱机,30例出院。第一组包括25例,血糖为(6.3±0.8)mmol/L,第二组包括19例,血糖为(10.7±2.3)mmol/L。两组患者死亡率及ECMO期间并发症无明显差异。结论现有数据尚不足以证实血糖水平与成人心脏外科术后ECMO治疗患者预后存在相关关系。OBJECTIVE In this study, we reviewed our experiences with extracorporeal membrane oxygenation support and tried to identify the relationship between blood glucose level and clinical outcomes. METHODS We retrospectively analyzed clinical records of 44 consecutive patients receiving ECMO support. Blood glucose levels were monitored and recorded every three hours during the support period. The mean blood glucose level was calculated for all patients for whom result data were available. Patients with mean blood glucose level≤8.9 mmol/L were allocated to group I. The others were allocated to group H. Clinical outcomes were compared between groups. A p value ≤ 0.05 was accepted as significant. RESULTS Twenty five patients were allocated to group I with mean blood glucose of （6.3 ± 0.8） mmol/L. The other 19 patients allocated to group II with mean blood glucose of （ 10.7± 2.3） mmol/L. There is no significant difference in the mortality of the two groups. Perioperative complications were also similar between the two groups. CONCLUSION Glucose level was not associated with mortality and complications in adult patients receiving extracorporeal membrane oxygenation.

关 键 词：成人 体外膜肺氧合 血糖 预后 

分 类 号：R654.1[医药卫生—外科学]