摘要
目的:探讨糖尿病患者骨科手术围手术期血糖控制的标准以及对手术的影响。方法:对96例骨疾病并存糖尿病的患者接受骨科手术治疗围手术期的血糖调控情况的分析。观察糖尿病患者术中、术后血糖(包括空腹血糖及早餐后2h血糖,2HPG)、尿酮体、有无低血糖反应、心脑并发症(包括心律失常、心肌梗死、心力衰竭、脑卒中),抗炎时间及切口愈合天数。结果:96例患者入院时空腹血糖(13.0±1.5)mmol/L,经术前用胰岛素控制血糖至(7.0±2.3)mmol/L后,分别接受全髋关节置换、股骨头置换、腰椎滑脱和钢板脊柱内固定系统复位固定等复杂骨科手术治疗,术中及术后继续用胰岛素控制血糖至基本正常水平,本组的术后血糖为(8.0±1.8)mmol/L。96例中,仅3例(3.1%)术后内固定松动,未发生感染和其他并发症。术后患者症状体征均明显改善,肢体功能恢复良好。结论:糖尿病患者经正确的围手术期处理,将血糖控制至基本正常水平,可耐受复杂的骨科手术。
Objective To investigate the standard of blood glucose control during perioperation to patients with diabetes complicating bone fracture and the influences to operation of blood glucose level. Methods 96 cases with diabetes complicating bone fracture were treated by means of operation, simultaneously, blood glucose level was also detected. The parameters observed includes blood glucose around operation （fasting and 2 hours after prandium blood glucose） ,urine acetone bodies,glycopenia responses, complications of heart and brain （including arrhythmia, myocardial infarction, cardiac failure and cerebral apoplexy） as ,well as the time of anti-inflammation and wound healing. Results The fasting blood glucose of the 96 cases was （ 13.0 ± 1.5 ） mmol/L on admission, after administration of insulin, it got （ 7.0 ± 2.3 ） mmol/L. All the 96 cases received operations respectively such as total hip replacement, femoral head replacement, abdominal vertebra olisthy and internal fixation within the backbone by steel strip, etc. Blood glucose level was controlled to normal with insulin around operation. The blood glucose was （8.0 ± 1.8 ） mmol/L after operation. However,3 of 96 cases exhibited internal fixation cinch after operation, and no infection and other complications occurred. The symptoms and physical signs improved obviously and the functions of limbs recovered nicely after operation. Conclusion Patients with diabetes can tolerate complicated orthopedic operations after correct management around operation keeping blood glucose nearly normal.
出处
《实用医技杂志》
2007年第8期1022-1023,共2页
Journal of Practical Medical Techniques
关键词
骨疾病
糖尿病
围手术期
血糖控制
Bone disease, Diabetes
Peri-operation
Blood glucose control
