非糖尿病患者在非体外循环下行CABG术围手术期血糖和血乳酸水平变化分析  

Analysis of Perioperative Blood Glucose and Blood Lactate Levels in Non-diabetic Patients Undergoing CABG without Cardiopulmonary Bypass

作　　者：胡坤其 冯增斌[1] 邓玉娇 HU Kun-qi;FENG Zeng-bin;DENG Yu-jiao(Department of Cardiac Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Endocrinology,Tianjin First Central Hospital,Tianjin 300070,China)

机构地区：[1]承德医学院附属医院心外科,河北承德067000 [2]天津市第一中心医院内分泌科,天津300070

出　　处：《医学信息》2019年第1期103-105,共3页Journal of Medical Information

摘　　要：目的回顾性分析非糖尿病患者行非体外循环冠状动脉旁路移植术(Off-Pump CABG)术前、术中、术后进入ICU血糖与血乳酸的变化趋势,探讨血糖与血乳酸之间的相关性。方法选取2016年10月～2018年7月承德医学院附属医院心外科50例择期行Off-Pump CABG的非糖尿病患者资料进行研究,观察术前血糖及血乳酸水平,分别为术前、术中1 h、2 h和术后在ICU 1、2、4、6、12、24、48 h各时间点的血乳酸及血糖水平并作趋势分析。结果患者随着手术及进入ICU时间的延长血乳酸水平均有增高趋势,血糖、血乳酸都有先升高到再次恢复正常的过程,并于进入ICU 4 h到达最高值;同时观察到血乳酸值与血糖值的变化趋势大致相同。通过一元线性回归分析血糖与乳酸的相关系数为0.350,单侧P=0.001,证明两个变量间有直线相关关系。结论积极控制Off-Pump CABG围手术期的血糖,能够减少高乳酸血症的发生,对于患者积极恢复及预后有积极意义。Objective To investigate the relationship between blood glucose and blood lactic acid in non-diabetic patients before and after off-pump coronary artery bypass grafting(Off-Pump CABG).Methods From October 2016 to July 2018, 50 patients with non-diabetic patients who underwent Off-Pump CABG in the Department of Cardiac Surgery, Affiliated Hospital of Chengde Medical College, were selected to observe preoperative blood glucose and blood lactate levels, respectively. Blood lactate and blood glucose levels were measured at 1 h, 2 h, and postoperative ICU at 1, 2, 4, 6,12, 24, and 48 h. Results The blood lactate level increased with the prolongation of surgery and ICU. The blood glucose and blood lactate increased first to normal again, and reached the highest value after entering the ICU for 4 h. At the same time, blood lactate was observed. The value is approximately the same as the change in blood glucose level. The correlation coefficient between blood glucose and lactic acid was 0.350 by one-dimensional linear regression, and one-sided P=0.001, which proved that there was a linear correlation between the two variables. Conclusion Active control of blood glucose during the perioperative period of Off-Pump CABG can reduce the incidence of hyperlactosis, which is positive for the positive recovery and prognosis of patients.

关 键 词：OFF-PUMP CABG 非糖尿病 血糖 血乳酸 

分 类 号：R654.2[医药卫生—外科学]