摘要
目的:探讨可乐定对2型糖尿病人围手术期血浆儿茶酚胺和血糖的影响。方法:40例2型糖尿病病人,随机分成两组,每组20例。可乐定组(K组):术前90 min给予可乐定4.5μg/kg;对照组(C组):术前90 min给予相同容量的生理盐水。麻醉诱导前和术中根据血糖水平使用胰岛素,术中使血糖浓度维持在11.1 mmol/L。静注硫喷妥钠、维库溴铵、芬太尼诱导插管,异氟醚、维库溴铵维持麻醉。麻醉诱导前(S1)、气管插管后(S2)、术中(S3)、气管拔管时(S4)、术后3 h(S5)和6 h(S6)分别采样测量血浆儿茶酚胺浓度;诱导前和手术结束后6 h以及术中测血糖浓度。结果:S1、S5、S6时血浆肾上腺素和去甲肾上腺素水平K组明显低于C组(P<0.05);各时点K组血糖浓度较C组明显降低(P<0.01),且胰岛素用量明显较C组少(P<0.05)。K组围术期血压、心率平稳。结论:可乐定可明显减少儿茶酚胺的释放,改善病人血糖水平,降低胰岛素的用量。
Objective： To investigate the effect of clonidine on catecholamine and blood glucose of type 2 diabetes in perioperative period. Methods： Forty patients with type 2 diabetes were randomly divided into two groups： clonidine group （n = 20） and control group （n = 20）. Clonidine （4.5 μg/ kg） were given in clonidine group 90min before anesthesia induction. The same volume of saline were given in control group 90 min before anesthesia induction. Levels of blood glucose were maintained between 5.5-11. 1 mmol/L with insulin during operation. Thiopental, fentanyl and vencurium were injected intravenously for induction and tracheal intubation. Anesthesia was maintained with Isoflurane and vencurium. Arterial plasma concentrations of catecholamine were measured before anesthesia（S1 ）, after intubation（S2 ）, 60 min after anesthesia（S3 ）,after extubation（S,）, 3 h （S5）and 6 h （S6） after operation. Arterial plasma concentrations of blood glucose were measured before anesthesia, during operation and 6 h after operation. Results： The epinephrine and norepinephrine concentration of clonidine group was lower than that of control group at S1 , S5 and S6 （P〈0.05）. The blood glucose concentration of clonidine group was lower than that of control group at all time points（P〈0.01）. The usage of insulin in clonidine group was lower than control group at all time points（P〈0.05）. Conclusion： Clonidine may reduce release of Catecholamine obviously, improve blood glucose control and decrease insulin usage.
出处
《武汉大学学报（医学版）》
CAS
2006年第1期119-121,共3页
Medical Journal of Wuhan University
关键词
儿茶酚胺
血糖
2型糖尿病
可乐定
围手术期
Catecholamine
Blood Glucose
Type 2 Diabetes
Clonidine
Perioperative Period
