主动脉弓部手术体外循环期间的血糖管理  

Management of blood glucose for extracorporeal circulation in aortic arch surgery

作　　者：刘海霞[1] 刘建华[1] 蒋伟[1] 

机构地区：[1]河南省胸科医院体外循环科,河南郑州450008

出　　处：《中国医药科学》2013年第3期173-174,176,共3页China Medicine And Pharmacy

摘　　要：目的通过监测主动脉弓部手术患者术中血糖变化,探讨合理的血糖管理方案。方法选择60例主动脉夹层的非糖尿患者,分为两组,每组30例,其中实验组将血糖控制在4.4～8.3mmol/L之间,对照组将血糖控制在8.4～11.1mmol/L之间。记录术后呼吸机辅助时间、ICU停留时间、术后住院天数、围术期心脏事件发生率、切口并发症及低血糖发生率。结果 (1)两组患者的一般情况相比差异无统计学意义(P>0.05)。(2)实验组患者的术后呼吸机辅助时间、IUC停留时间、围术期心脏事件和切口并发症发生率明显减少(P<0.05),术后住院时间及低血糖发生率差异无统计学意义(P>0.05)。结论围术期强化胰岛素治疗可缩短术后呼吸机辅助时间、围术期心脏事件发生率、降低切口并发症发生率和ICU停留时间,改善预后,是一种合理有效的血糖控制方案。Objective To investigate the changes of blood glucose for extracorporeal circulation in aortic arch surgery, therefore to assess the optimal glucose control goal. Methods 60 eases of aortic arch replacement were randomLy divided into two groups（n=30）.In the test group blood glucose were controlled between 4.4 ~ 8.3 mmol/L, and in the control group blood glucose were controlled between 8.4 ~ 11.1 mmol/L, Record the assisted ventilation time,the length of stay in ICU,the hospitalization time,the incidence of major adverse cardiovascular events,incisi0n tom- plications and hypoglycemia. Results （1）There were no significant differe- nces in patients＇general conditions between two groups（P 〉 0.05）.（2）The assisted ventilation time, the length of stay in ICU, the incidence of major adverse cardiovascular events and incision complications were Significantly reduce in the test group（P 〈 0.05）,the hospitalization time and hypoglycemia,difference of two set of patients have no stati- tics significance（P 〉 0.05）. Conclusion Intensive insulin therapy could reduce the assisted ventilation time, the length of stay in ICU, the incidence of major adverse cardiovascular events and incision complicat- ions, and was proved to be a kind effectively control scheme for blood glucose.

关 键 词：高血糖 胰岛素 体外循环 

分 类 号：R654.31[医药卫生—外科学]