肥胖患者椎管内麻醉后发生低血糖的影响因素  

Factors Influencing Hypoglycemia in Obese Patients after Spinal Anesthesia

作　　者：张延娇 韩萍 ZHANG Yanjiao;HAN Ping(Department of Anesthesiology,Baoji People's Hospital,Baoji Shaanxi 721006)

机构地区：[1]宝鸡市人民医院麻醉科,陕西宝鸡721006

出　　处：《医学临床研究》2025年第1期99-101,共3页Journal of Clinical Research

摘　　要：【目的】探讨肥胖患者在接受椎管内麻醉后发生低血糖的情况及其影响因素。【方法】80例接受椎管内麻醉的肥胖患者,根据麻醉后是否发生低血糖分为低血糖组(32例)和非低血糖组(48例),收集所有患者的临床资料进行分析,采用单因素方差分析初步筛选发生低血糖的风险因素,并进一步采用多因素Logistic回归分析肥胖患者在麻醉后发生低血糖的独立危险因素。【结果】单因素分析结果显示,体重指数(BMI)过高、糖尿病、高血压、手术时间过长、术前禁食时间过长均与肥胖患者椎管内麻醉后发生低血糖有关(P<0.05)。多因素Logistic回归分析显示,BMI过高、糖尿病、手术时间过长均为肥胖患者麻醉后发生低血糖的危险因素(P<0.05)。【结论】对于肥胖患者,特别是存在糖尿病等并发症的患者,在接受椎管内麻醉前应严格控制体重,注意手术时间的控制,从而有效降低患者在麻醉后发生低血糖的风险。【Objective】To investigate the occurrence and influencing factors of hypoglycemia in obese patients following spinal anesthesia.【Methods】Eighty obese patients who underwent spinal anesthesia were enrolled in the study.They were divided into two groups based on whether they developed hypoglycemia after anesthesia:the hypoglycemia group(32 cases)and the non-hypoglycemia group(48 cases).Relevant clinical data of all patients were collected and analyzed.A preliminary screening of risk factors for hypoglycemia was conducted using univariate analysis of variance,followed by a multivariate logistic regression analysis to identify independent risk factors for hypoglycemia in obese patients after anesthesia.【Results】Univariate analysis showed that a high body mass index(BMI),the presence of diabetes,hypertension,prolonged surgery duration,and extended preoperative fasting time were all associated with the occurrence of hypoglycemia in obese patients following spinal anesthesia(P<0.05).Multivariate Logistic regression analysis revealed that a high BMI,the presence of diabetes,and prolonged surgery duration were independent risk factors for hypoglycemia after anesthesia in obese patients(P<0.05).【Conclusion】For obese patients,especially those with complications such as diabetes,strict weight control and careful management of surgery duration before undergoing spinal anesthesia are essential to effectively reduce the risk of postoperative hypoglycemia.

关 键 词：肥胖症 麻醉 脊椎 低血糖症 影响因素分析 

分 类 号：R446.112[医药卫生—诊断学]