摘要
目的 :探讨髋关节置换术应用骨水泥对老年糖尿病患者和非糖尿病患者血糖的不同影响。方法 :30例 (年龄 6 5～ 87岁 ,平均 6 8.7岁 )按入院时空腹血糖值分为两组 ,A组 :12例 ,空腹血糖≥10 mmol/ L,经饮食控制和胰岛素治疗 ,将血糖控制在平均值为 6 .0± 1.0 mmol/ L ;B组 :18例 ,空腹血糖平均值为 4 .75± 1.12 mmol/ L ,经常规术前准备。两组均在相对固定的时间以“One Touch”仪采血测定血糖值 :1麻醉 (T1) ;2置入骨水泥前 5min(T2 ) ;3置入骨水泥后 5min(T3) ;4术终 (T4 ) ;5术后 d1(T5) ;6术后 d3(T6 )。结果 :T2、T3、T4、T5血糖值 A组分别为 5.11± 0 .4 3,6 .4 7± 1.77,6 .13± 0 .78,5.34± 0 .98mmol/ L;B组分别为 6 .72± 0 .81,7.14± 1.0 7,7.0 6± 0 .6 7,6 .6 9± 0 .76 mmol/ L。术中两组血糖值均高于术前 (P<0 .0 1～ 0 .0 5)。填塞骨水泥加剧了血糖的变化 ,两组组间比较存在明显的差异 (P<0 .0 5)。 A组有 3例在术中发生了低血糖反应。结论 :填塞骨水泥加剧了血糖值的变化。对接受髋关节置换手术的老年糖尿病患者或非糖尿病患者进行血糖监测是必要的。
Objectives:[WT5BZ]To evaluate difference of bone cement on blood glucose level between elderly patients with or without diabetes mellitus during total hip replacement surgery.[WT5HZ]Methods:[WT5BZ]Thirty patients(aging 65 87 years)were allocated to two groups according to fasting blood glucose level on admisson.Group A:fasting blood glucose level of 12 cases was ≥10mmol/L(average 12.82±1,3mmol/L)and was controlled to 4.82±1.03mmol/L by using insulin and dieatry before surgery.Group B:fasting blood glucose level of 18 cases was ≤16mmol/L(average±1.12mmol/L)with ordinary preoperative management.The blood glucose level of every patient was arrayed by“One Touch”at six same time:①before anesthesia(T1);②5 minute before filling up the bone cement(T2);③5 minute after filling up the bone cement(T3);④at the end of operation(T4);⑤the first day postoperatively(T5);⑥the third day postoperatively(T6).[WT5HZ]Results:[WT5BZ]Blood glucose levels at T2,T3,T4and T5 were 5.11±0.43,6.47±1.77,6.130.78,5.34±0.98mmol/L in group A and were 6.72±0.81,7.14±1.07,7.06±0.67,6.69±0.76mmol/L in group B.The concentrations of blood glucose of both groups were higher than those of preoperation respectively(P<0.01～0.05),filling up bone cement also exaggerated blood glucose level to change.There was significant difference between group A and B(P<0.05).3 patients with hypoglycemia were seen during operation in group A.[WT5HZ]Conclusion:[WT5BZ]Filling up bone cement may axaggerate blood glucose level to change.Blood glucose level monitor can be acceptable in elderly patients with or without diabetes mellitus during hip replacement surgery. [WT5HZ]
出处
《河北医学》
CAS
2000年第7期579-581,共3页
Hebei Medicine
关键词
髋关节置换术
骨水泥
血糖
老年人
WT5BZ]Total hip replacement
Bone cement
Blood glucose
