冠状动脉旁路移植术后患者高血糖预后分析  

Prognosis analysis of post-operative hyperglycemia in patients post coronary artery bypass grafting

作　　者：刘莉[1] 张黎瑛[1,2] 周营营 胡莉娟 朱蕾 

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]上海交通大学附属第九人民医院急诊科

出　　处：《中国实用内科杂志》2008年第S1期83-85,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的研究术后高血糖对冠状动脉旁路移植术(CABG)后患者病情和预后的影响。方法选择复旦大学附属中山医院2005年1月至12月行CABG的患者,收集患者一般情况、实验室检查、治疗及预后等资料,根据术后血糖水平分为术后高血糖组和术后正常血糖组;前者又根据术前是否存在糖尿病分为应激性高血糖组和糖尿病高血糖组两个亚组。比较两组及两亚组间治疗与预后的差异,并评价影响预后的因素。结果共纳入200例患者,术后高血糖发生率77%,术后高血糖患者的多器官功能不全综合征(MODS)发生率高、机械通气时间长、病情重,其中24h平均血糖是对预后有独立作用的变量。结论术后高血糖明显升高冠状动脉旁路移植术后并发症的发生率及病死率,控制术后24h平均血糖,有利于改善预后。Objective To observe the effect of post-operative hyperglycemia on the state and prognosis in patients post coronary artery bypass grafting(CABG).MethodsPatients who had CABG surgery in Zhongshan Hospital from January 2005 to December 2005 were enrolled.Data were collected including the general information,laboratory examination,information of therapy and prognosis.The patients were divided into post-operative hyperglycemia and post-operative normal blood glucose group according to post-operative blood glucose(BG)levels,and then according to the diabetic history,the former was devided into subgroup of stress hyperglycemia group and diabetes mellitus hyperglycemia group.The above data were compared and analyzed between the two groups,and the two subgroups.The important factors associated with prognosis were studied.Results200 patients were enrolled in this study.The incidence of post-operative hyperglycemia was 77%.The post-operative hyperglycemia group presented a higher incidence of MODS,longer MV time,and poorer prognosis than the post-operative normal BG group.The average glucose in 24 hours was independed associated with mortality.ConclusionThe incidence of complications and mortality is higher in the patients with post-operative hyperglycemia,so controlling the average glucose in 24 hours may improve the prognosis.

关 键 词：术后高血糖 冠状动脉旁路移植术后 

分 类 号：R587.1[医药卫生—内分泌] R654.2[医药卫生—内科学]