糖尿病患者术前即刻高血糖与胸腔镜肺部分切除术后肺部并发症的关系  

Association of immediate preoperative hyperglycemia with postoperative pulmonary complications in patients with diabetes mellitus following video-assisted thoracoscopic partial lung surgery

作　　者：张扬 ELAMIN SARA MUSA ABDALLA 朱琳佳 陈紫璇 查天明 桂波 Zhang Yang;Elamin Sara Musa Abdalla;Zhu Linjia;Chen Zixuan;Zha Tianming;Gui Bo(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Anesthesiology,Geriatric Hospital of Nanjing Medical University,Nanjing 210009,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围术期医学科,南京210029 [2]南京医科大学附属老年医院麻醉科,南京210009

出　　处：《中华麻醉学杂志》2025年第2期152-155,共4页Chinese Journal of Anesthesiology

摘　　要：目的探讨糖尿病患者术前即刻高血糖(IPH)与胸腔镜肺部分切除术后肺部并发症(PPCs)的关系。方法本研究为回顾性队列研究。对2018年1月至2020年7月在南京医科大学第一附属医院行择期胸腔镜肺部分切除术糖尿病患者进行回顾性调查。根据术前即刻血糖(术前2 h内空腹血糖)水平分为高血糖组(IPH组, 血糖浓度≥7.8 mmol/L)和非高血糖组(non-IPH组, 血糖浓度<7.8 mmol/L), 采用倾向性评分匹配法分析IPH与PPCs发生的关联情况。结果本研究最终收集438例患者胸腔镜肺部分切除术的病历数据。与non-IPH组相比, IPH组患者PPCs发生率明显升高(P<0.001)。倾向性评分匹配后, IPH组与non-IPH组均为128例, IPH组患者发生PPCs的风险是non-IPH组的1.33倍(相对危险度为1.33, 95%置信区间1.02~1.73, P=0.031), 且年龄因素与术前糖化血红蛋白水平对IPH未见交互作用。结论 IPH(术前2 h内空腹血糖≥7.8 mmol/L)与糖尿病患者胸腔镜肺部分切除术PPCs发生有一定的关联。Objective To investigate the association of immediate preoperative hyperglycemia(IPH)with postoperative pulmonary complications(PPCs)in patients with diabetes mellitus following video-assisted thoracoscopic partial lung surgery(VATPLS).MethodsThis was a retrospective cohort study.The patients with diabetes mellitus who underwent elective VATPLS at the First Affiliated Hospital of Nanjing Medical University from January,2018 to July,2020 were recruited.Based on immediate preoperative blood glucose levels(fasting blood glucose within 2 h before surgery),the patients were divided into hyperglycemia group(IPH group,blood glucose concentration≥7.8 mmol/L)and non-hyperglycemia group(non-IPH group,blood glucose concentration<7.8 mmol/L).The association of IPH with the occurrence of PPCs was analyzed using the prospensity score matching.ResultsData from 438 diabetic patients who underwent VATPLS were ultimately collected in this study.Compared with non-IPH group,the incidence of PPCs was significantly increased in IPH group(P<0.001).After propensity score matching,128 cases were assigned to both IPH group and non-IPH group,the risk of PPCs in IPH group was 1.33 times of that in non-IPH group(relative risk 1.33,95%confidence interval 1.02-1.73,P=0.031).There were no interactions between age factors/preoperative glycated hemoglobin and IPH.ConclusionsIPH(fasting blood glucose within 2 h before surgery≥7.8 mmol/L)is associated with the occurrence of PPCs to some degree in patients with diabetes mellitus undergoing VATPLS.

关 键 词：手术前期间 高血糖症 糖尿病 胸外科手术 电视辅助 肺切除术 术后肺部并发症 

分 类 号：R655.3[医药卫生—外科学]