围手术期血糖控制的相关问题  

Perioperative blood glucose control

作　　者：周岩冰[1] 刘汉成[1] 

机构地区：[1]青岛大学医学院附属医院普通外科,266003

出　　处：《中华胃肠外科杂志》2012年第6期544-545,共2页Chinese Journal of Gastrointestinal Surgery

摘　　要：高血糖可对机体产生严重不良影响，糖尿病患者手术并发症发生率和病死率明显增加．手术应激引起的高血糖和胰岛素抵抗也可产生同样不良后果．围手术期患者的代谢状态、麻醉方法、外源性葡萄糖输注、应激引起的神经内分泌反应及胰岛素抵抗等均可影响围手术期血糖的水平，且造成患者临床结局不良。严格血糖控制与降低手术后患者死亡率和并发症发生率的关系尚不明确。血糖控制对围手术期患者是必须的．但是控制的理想状态仍需要多中心临床试验证据的支持。目前普遍认为围手术期血糖控制在10mmol／L以下即可．严格血糖控制的有效性及安全性有待进一步观察。Hyperglycemia can result in severe adverse effects on the body. The mortality and morbidity of surgery are increased significantly in diabetic patients. The surgical stress- related hyperglycemia and insulin resistance can also produce the same adverse consequences. The metabolic state of the surgical patients, anesthesia method, glucose infusion, stress- induced neuroendocrine responses and insulin resistance can affect the perioperative blood glucose levels, resulting in poor clinical outcomes. The relationship between tight glycemic control and reducing post-operative mortality and morbidity is not clear. It＇s necessary to control blood sugar level during the perioperative period but the ideal state of glycemic control still needs a mult-center clinical trial evidence. It is generally believed that perioperative blood glucose level should be controled below 10 mmol/L. The efficacy and safety of tight glycemic control needs further study.

关 键 词：严格血糖控制 应激性高血糖 胰岛素抵抗 围手术期 

分 类 号：R619[医药卫生—外科学]