手术时长与内眼手术围手术期血糖波动的相关分析  

Correlation between changes in blood glucose levels and the duration of surgery in the perioperative period

作　　者：高朗 陈红梅[1] 白晔 秦雪娇[1] GAO Lang;CHEN Hongmei;BAI Ye;QIN Xuejiao(Department of Ophthalmology,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Ophthalmology,Taihe County Fifth People's Hospital,Fuyang 236000,Anhui,China;Department of Ophthalmology,Xi'an fourth Hospital,Xian 710000,Shanxi,China)

机构地区：[1]山东大学齐鲁医院眼科,山东济南250012 [2]安徽省阜阳市太和县第五人民医院眼科,安徽阜阳236000 [3]西安市第四医院眼科,陕西西安710000

出　　处：《山东大学耳鼻喉眼学报》2021年第4期70-75,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省自然科学基金(ZR201702190277);济南市临床医学科技创新计划(201704122);山东大学齐鲁医院临床新技术启动基金(2017-10)。

摘　　要：目的控制血糖波动是目前糖尿病防控的新关注点,论文重点研究手术时长对内眼手术后血糖变化的影响,同时分析影响血糖波动幅度的相关临床因素,为该类患者的围手术期血糖管理提供参考依据。方法搜集2016年1月至2017年5月收治的糖尿病合并眼部疾病并接受内眼手术的患者132例。所有患者接受以下时间点的血糖测定:手术前空腹血糖、手术前即时血糖、手术后30 min血糖、术后第1天空腹血糖、术后第1天相应手术前时间点血糖、术后第2天空腹血糖、术后第2天相应手术前时间点血糖,采用配对t检验比较手术前后患者血糖变化。术后30 min与术前即时血糖的差值为术后30 min的血糖变化值(BGC),术后第1天相应时间点、术后第2天相应时间点与术前相应时间点的血糖差值分别为术后1 d时间点BGC和术后2 d时间点BCG,术后第1天空腹血糖、术后第2天空腹血糖与手术前空腹血糖的差值分别为术后1天空腹BCG和术后2天空腹BCG。按照手术时间长短将患者分为三组:短组(手术时间≤30 min)、中组(手术时间31~90 min)、长组(手术时间>90 min)。根据术前即时血糖将患者分为两组:即时血糖低组(术前血糖≤10 mmol/L)、即时血糖高组(术前血糖>10 mmol/L)。根据术前空腹血糖将患者分为两组:空腹血糖低组(术前空腹血糖≤8.33 mmol/L)、空腹血糖高组(术前空腹血糖>8.33 mmol/L)。依据糖尿病确诊后的病程,将患者分为三组:短组(病程在≤5年)、中组(5年<病程<10]年)、长组(病程>10年)。结果132例患者术前即时血糖平均为(9.81±1.29)mmol/L,术后30 min为(13.04±1.83)mmol/L,两者比较有统计学差异。术后第1天(11.03±1.16 mmol/L)、第2天(10.10±1.47 mmol/L)相应时间点的血糖较手术前(9.81±1.29 mmol/L)血糖升高,差异有统计学意义。术后30 min BGC,短组(1.86±1.71 mmol/L)、中组(3.20±2.01 mmol/L)与长组(3.50±2.13 mmol/L)之间两两比较差异均�Objective To prevent and treat diabetes,it is necessary to monitor the fluctuation in blood glucose levels.This study provides a reference for the perioperative clinical monitoring of patients with diabetes by studying the changes in blood glucose levels before and after ocular surgeries and evaluating the factors that influence these changes.Methods We recruited 132 patients with ocular diseases and diabetes from Qilu Hospital,Shandong University between January 2016 and May 2017.All patients underwent blood glucose tests one day before surgery(fasting,2 h after breakfast,2 h after lunch,and at 10 pm)and 30 min to 2 days after surgery.The blood glucose levels before and after surgery were compared using a paired t-test.To study the factors influencing the changes in blood glucose levels,we divided the patients into three groups according to the duration of surgery-short duration group(<30 min),medium duration group(31-90 min),and long duration group(>90 min).Further,we divided patients into two groups according to the preoperative instant blood glucose level-low instant blood glucose group(73 patients with preoperative fasting blood glucose levels≤10 mmol/L)and high instant blood glucose group(59 patients with preoperative fasting blood glucose levels>10 mmol/L).According to the preoperative fasting blood glucose level,patients were divided into two groups-low fasting blood glucose group(62 patients with preoperative fasting blood glucose levels≤8.33 mmol/L)and high fasting blood glucose group(70 patients with preoperative fasting blood glucose levels>8.33 mmol/L).According to the history of diabetes,patients were divided into three groups-short history group(≤5 years),middle history group(5-10 years),and long history group(>10 years).Results The average blood glucose level was 9.81±1.29 mmol/L and 13.04±1.83 mmol/L before surgery and 30 min after surgery,respectively,with an average increase of 3.22±2.19 mmol/L(paired t-test,P<0.01).There were no significant differences between the sexes.Blood glucose

关 键 词：内眼手术 血糖波动 影响因素 手术时长 糖尿病 

分 类 号：R770.41[医药卫生—眼科]