围术期严重高血糖对心脏瓣膜置换术患者预后的影响  

Effect of Severe Hyperglycemia During Perioperative Period on Prognosis of Patients Undergoing Cardiac Valve Replacement

作　　者：刘巧萍[1] 郭依清 齐娟[1] 雷立华[1] LIU Qiaoping;GUO Yiqing;QI Juan;LEI Lihua(Department of Anesthesiology,Fujian Provincial Hospital,Provincial Clinic College of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院麻醉科,福州350001

出　　处：《福建医科大学学报》2020年第1期44-47,共4页Journal of Fujian Medical University

摘　　要：目的回顾性研究围术期严重高血糖对心肺转流(CPB)心脏瓣膜置换术患者术后并发症及预后的影响。方法将211例CPB心脏瓣膜置换术的患者根据围术期最高血糖值进行分组(≥13.9 mmol/L为严重高血糖组,<13.9 mmol/L为非严重高血糖组),收集所有患者围术期血糖值、一般资料及手术资料。采用t检验、χ2检验或者Fisher确切概率法对2组患者进行术前、术中和术后资料分析,采用Logistic回归和线性回归方程分析并发症的危险因素。结果围术期血糖≥13.9 mmol/L为肺部感染的危险因素(OR=2.20,95%CI=1.26~3.83,P=0.005),机械通气时间(Coef.=0.42,P<0.001)、ICU住院时间(Coef.=0.53,P<0.001)和住院时间(Coef.=0.42,P=0.007)均与围术期血糖最大值呈正相关。结论心脏瓣膜置换术围术期严重高血糖是肺部感染的危险因素,围术期高血糖与延长的机械通气时间、ICU住院时间和总住院时间相关。Objective To retrospectively study the effect of perioperative severe hyperglycemia on postoperative complications and prognosis of patients who undergo cardiopulmonary bypass(CPB)cardiac valve replacement.Methods According to the maximum perioperative blood glucose value,211 patients with CPB cardiac valve replacement were divided into two groups(≥13.9 mmol/L as hyperglycemia group,<13.9 mmol/L group as non-severe hyperglycemia group).Perioperative blood glucose value,population characteristics and surgical data were collected.Preoperative,intraoperative,and postoperative data were analyzed by t test,Chi-square test,or Fisher exact probability.Logistic regression and linear regression equation were used to analyze the risk factors of complications.Results Perioperative blood glucose level≥13.9 mmol/L was a risk factor for pulmonary infection(OR=2.20,95%CI=1.26~3.83,P=0.005),and mechanical ventilation time(Coef.=0.42,P<0.001),(Coef.=0.53,P<0.001),ICU hospitalization time,and total hospital stay(Coef.=0.42,P=0.007)were positively correlated with the maximum perioperative blood glucose.Conclusion Perioperative severe hyperglycemia during heart valve replacement is a risk factor for pulmonary infection.Perioperative hyperglycemia is associated with prolonged mechanical ventilation,ICU stay,and total hospital stay.

关 键 词：手术期间 血糖/分析 高血糖症 心脏瓣膜 人工 心肺转流术 

分 类 号：R318.22[医药卫生—生物医学工程] R619[医药卫生—基础医学]