糖尿病与颈动脉内膜剥脱术后并发症发生率的相关性分析  

Correlation analysis between diabetes mellitus and the incidence of complications after carotid endarterectomy

作　　者：张鹏[1] 王志强[1] 王浩 张西科 商淑玲 冯青叶 兴辰 曹英肖 ZHANG Peng;WANG Zhiqiang;WANG Hao;ZHANG Xike;SHANG Shuling;FENG Qingye;XING Chen;CAO Yingxiao(Department of Neurosurgery,Handan First Hospital,Handan 056000,China)

机构地区：[1]邯郸市第一医院神经外科,邯郸056000 [2]河北医科大学附属邢台市人民医院神经外科 [3]河北省眼科医院

出　　处：《临床神经外科杂志》2025年第2期210-214,共5页Journal of Clinical Neurosurgery

基　　金：河北省邢台市重点研发计划项目(2024ZC112)。

摘　　要：目的 探讨糖尿病与颈动脉内膜剥脱术(CEA)术后并发症发生率之间的相关性。方法 纳入2012年1月—2022年12月在邯郸市第一医院及邢台市人民医院接受CEA的370例患者,根据是否合并糖尿病分为糖尿病组与非糖尿病组。糖尿病组共139例(37.6%),其中50例为主要应用胰岛素治疗糖尿病的患者(36.0%),89例为仅应用口服降糖药物治疗糖尿病的患者(64.0%);非糖尿病组共231例(62.4%)。结果 除糖尿病患者的血脂异常、冠心病、外周血管疾病患病率较高外,其余患者的术前特征相似。糖尿病患者术后脑血管病发生率(3.6%)显著高于非糖尿病患者(0.4%)(P=0.03);糖尿病患者术后心力衰竭发生率(5.8%)显著高于非糖尿病患者(1.3%)(P=0.023);糖尿病患者术后伤口感染发生率(3.6%)显著高于非糖尿病患者为(0%)(P=0.007)。致死性心脏事件、神经系统事件及死亡率两组间无统计学意义(P>0.05)。糖尿病组术后总并发症的比例是非糖尿病组的2倍以上(分别为20.1%和7.4%,P<0.001)。结论 糖尿病增加了CEA的手术风险,但致死性风险并无明显增加。仅接受口服降糖药物治疗的患者比胰岛素治疗的患者有更高的CEA术后并发症发生率。Objective To explore the correlation between diabetes and the incidence of complications after carotid endarterectomy(CEA).Methods A total of 370 patients who received CEA at Handan First Hospital and Xingtai People's Hospital from January 2012 to December 2022 were collected.According to whether diabetes mellitus is complicated or not,the subjects were divided into diabetic group and non-diabetic group.Diabetic group had 139 patients(37.6%),while 50 patients with diabetes mainly treated with insulin(36.0%),89 patients with diabetes treated only with oral hypoglycemic drugs(64.0%).Non-diabetic group had 231 patients(62.4%).Results Except for the high prevalence of dyslipidemia,coronary heart disease and peripheral vascular disease in patients with diabetes,the preoperative characteristics of other patients were similar.The incidence of postoperative cerebrovascular disease in diabetic patients(3.6%) was higher than that in non-diabetic patients(0.4%)(P=0.03).The incidence of postoperative heart failure in diabetic patients(5.8%) was higher than that in non-diabetic patients(1.3%)(P=0.023).The incidence of postoperative wound infection was 3.6% in diabetic patients and 0% in non-diabetic patients(P=0.007).There was no significant difference in fatal cardiac events,neurological events and mortality between the two groups(P>0.05).The proportion of total post-operative complications in the diabetic group was more than twice as high as that in the non-diabetic group(20.1%vs 7.4%,P<0.001).Conclusions Diabetes increases the surgical risk of CEA,but there is no significant increase in the risk of fatality.It is observed that patients only treated with oral hypoglycemic drugs have a higher incidence of post-operative complications than patients treated with insulin.

关 键 词：颈动脉内膜剥脱术 糖尿病 术后并发症 

分 类 号：R651[医药卫生—外科学] R743[医药卫生—临床医学]