文章摘要
李选发,唐婧英,徐志新,刘丽丽,韦雪梅.不同血糖水平对体外循环心脏手术围术期患者血乳酸以及康复进程的影响[J].,2019,19(13):2534-2538
不同血糖水平对体外循环心脏手术围术期患者血乳酸以及康复进程的影响
Influence of Different Blood Sugar Level on Blood Lactate and Rehabilitation Process in Patients with Cardiopulmonary Bypass Cardiac Surgery
投稿时间:2018-10-28  修订日期:2018-11-24
DOI:10.13241/j.cnki.pmb.2019.13.030
中文关键词: 体外循环  心脏手术  血糖  血乳酸  康复进程  并发症
英文关键词: Cardiopulmonary bypass  Cardiac surgery  Blood sugar  Blood lactate  Rehabilitation process  Complication
基金项目:海南省卫计委卫生科研项目(A2015927835)
作者单位E-mail
李选发 海南医学院第二附属医院麻醉科 海南 海口 570311 kwegio@163.com 
唐婧英 海南省人民医院麻醉科 海南 海口 570311  
徐志新 海南医学院第二附属医院麻醉科 海南 海口 570311  
刘丽丽 海南医学院第二附属医院麻醉科 海南 海口 570311  
韦雪梅 海南医学院第二附属医院麻醉科 海南 海口 570311  
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中文摘要:
      摘要 目的:探讨体外循环(CPB)心脏手术围术期患者不同血糖水平对血乳酸值及术后康复进程的影响。方法:选择2016年3月至2018年5月在我院行CPB心脏手术的患者78例为研究对象,根据术前血糖水平分为糖尿病组(术前空腹血糖≥7.0 mmol/L)33例和非糖尿病组(术前空腹血糖<7.0 mmol/L)45例,于术前2h(T1)、麻醉后(T2)、CPB转机后5 min(T3)、主动脉阻断后5 min(T4)、停止CPB时(T5)、手术结束时(T6)、术后2h(T7)、4h(T8)、6h(T9)、8h(T10)、12h(T11)、24h(T12)及48h(T13)监测两组血糖及血液乳酸水平,比较两组康复进程指标及并发症发生情况。结果:糖尿病组患者围手术期各时间点血糖及血乳酸水平均高于非糖尿病组,且两组血糖与血乳酸水平呈正相关(P<0.05);两组各时间点血糖及血乳酸水平均高于T1时刻(P<0.05)。非糖尿病组患者呼吸机辅助通气时间、ICU停留时间、术后住院时间均短于糖尿病组(P<0.05)。非糖尿病组并发症发生率为4.44%(2/45),与糖尿病组的15.15%(5/33)比较无统计学差异(P>0.05)。结论:CPB心脏手术患者围术期血糖及血乳酸水平明显升高,二者呈正相关关系,但术前糖尿病患者围手术期血糖及血乳酸水平波动更明显,控制围手术期血糖水平有助于加快康复进程。
英文摘要:
      ABSTRACT Objective: To explore the influence of different blood sugar level on blood lactate and rehabilitation process in patients with cardiopulmonary bypass (CPB) cardiac surgery at perioperative period. Methods: 78 patients with CPB cardiac surgery who were treated in our hospital from March 2016 to May 2018 were selected as the objects, the patients were divided into diabetes mellitus group (preoperative fasting blood sugar≥7.0 mmol/L) with 33 cases and non diabetes mellitus group (preoperative fasting blood sugar<7.0mmol/L) with 45 cases according to the preoperative blood sugar level,the blood sugar and blood lactate level in the two groups were monitored at the 2h before operation (T1), after anesthesia (T2), 5 min CPB after the transfer (T3), 5 min after aortic blocking-up (T4), end of CPB (T5), end of the operation (T6), 2h after operation (T7), 4h (T8/sub>), 6h (T9), 8h (T10), 12h (T11), 24h (T12) and 48h (T13), the indexes of rehabilitation process and complications were compared between the two groups. Results: The blood sugar and blood lactate levels in the diabetes mellitus group at each time of perioperative period were higher than those in the non-diabetic group,and there was a positive correlation between the two groups of blood glucose and blood lactic acid level (P<0.05). The blood glucose and blood lactate levels of the two groups at each time point were higher than that of T1 (P<0.05). The ventilator assisted ventilation time, ICU stay time and postoperative hospital stay in the non diabetes mellitus group were shorter than those in the diabetes mellitus group(P<0.05). The incidence of complications was 4.44%(2/45) in the non diabetes mellitus group, there was no significant difference of 15.15%(5/33) in the diabetes mellitus group (P>0.05). Conclusion: The blood sugar and blood lactate levels in CPB patients with cardiac surgery at perioperative increase significantly, there was a positive correlation, but the blood sugar and blood lactate levels fluctuat more obviously in the preoperative diabetes patients, controlling the blood sugar level during perioperative period is helpful to speed up the rehabilitation process.
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