不同麻醉方式对老年糖尿病患者全膝置换术后糖代谢的影响  

Effects of Different Anesthesia Methods on Glucose Metabolism in Elderly Diabetic Patients after Total Knee Replacement

作　　者：刘珊珊[1] 杨学林[1] 孙玉娥[1] 周瑜[1] 蒋忠[1] LIU Shan-shan;YANG Xue-lin;SUN Yu-e;ZHOU Yu;JIANG Zhong(Department of Anesthesiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《现代生物医学进展》2021年第3期459-462,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81870871);南京市卫生科技发展项目(ZKX18018)。

摘　　要：目的:探讨不同麻醉方式对老年糖尿病患者全膝置换术(total knee arthoplasty,TKA)后糖代谢的影响。方法:2018年2月到2020年3月选择在本院进行择期TKA的老年糖尿病合并膝关节骨性关节炎患者88例,随机原则分为研究组与对照组,各44例。对照组给予常规静吸复合全身麻醉,研究组在对照组麻醉的基础上给予复合股神经阻滞,检测两组术后空腹血糖值,并记录两组膝关节功能改善情况。结果:研究组术后1 d、3 d与7 d静息状态下和活动状态下的疼痛视觉模拟评分法(Visual Analogue Scale/Score,VAS)评分都显著低于对照组(P<0.05)。研究组术后1 d、3 d与7 d的空腹血糖值都显著低于对照组(P<0.05)。研究组术后1 d、3 d与7 d的患肢膝关节活动度都显著高于对照组(P<0.05)。结论:股神经阻滞联合全麻在老年糖尿病患者TKA中的应用能缓解术后疼痛,减低术后血糖水平,并且促进提高膝关节活动度有益预后。Objective: To explore the effects of different anesthesia methods on the glucose metabolism after total knee arthoplasty(TKA) in elderly diabetic patients. Methods: From February 2018 to March 2020, 88 cases of elderly patients with diabetes and knee osteoarthritis who underwent elective TKA in our hospital were selected as the research object. The patients were divided into research group and control group of 44 cases in each groups accorded to the principle of random envelope drawing The control group were given routine intravenous inhalation combined with general anesthesia, and the research group were given compound femoral nerve block on the basis of the control group anesthesia. The postoperative fasting blood glucose values of the two groups were detected, and the improvement of knee joint function in the two groups were recorded. Results: The visual analogue scale/score(VAS) scores of pain in resting and active states on the 1 st, 3 d and 7 d postoperatively in the study group were significantly lower than those in the control group(P<0.05). The fasting blood glucose values of the research group at 1 d, 3 d and 7 d postoperative days were significantly lower than those of the control group(P<0.05). The knee joint mobility of the affected limb at 1 d, 3 d and 7 d postoperative days in the research group were significantly higher than that in the control group(P<0.05). Conclusion: The application of femoral nerve block combined with general anesthesia in TKA of elderly diabetic patients can relieve postoperative pain, reduce postoperative blood glucose levels, and promote the improvement of knee joint mobility and beneficial prognosis.

关 键 词：股神经阻滞 老年人 糖尿病患 全膝置换术 糖代谢 

分 类 号：R587.2[医药卫生—内分泌] R687[医药卫生—内科学]