体外循环心脏手术患者围术期血糖及乳酸变化

发布时间：2018-06-18 06:41

本文选题：体外循环 + 血糖　；参考：《首都医科大学学报》2015年01期

【摘要】：目的回顾性分析体外循环(cardiopulmonary bypass,CPB)下心脏手术患者围术期血糖和血乳酸的变化趋势。方法选取2013年1月至12月期间在首都医科大学宣武医院行体外循环心脏手术的成年患者58例,根据术前是否合并糖尿病分非糖尿病组和糖尿病组,根据体外循环时间分为CPB时间小于2 h组(A组)和大于2 h组(B组)。观察围术期血糖值和乳酸值的变化趋势,并对相关临床资料进行分析。结果 58例患者体外循环时间59~315 min,平均(126.07±50.74)min,阻断时间35~161 min,平均(67.61±22.95)min,自动复跳率52%,术中血糖及血乳酸从麻醉诱导后呈逐渐升高趋势,Pearson检验示两者之间呈正相关(r=0.939,P=0.018),手术结束时血糖升至最高随后逐渐下降。结论体外循环对合并糖尿病患者围术期血糖的影响更明显,控制围术期血糖有助于降低血乳酸。提高CPB的管理水平,有利于术中及术后血糖及乳酸值的改善,从而降低术后相关合并症,改善预后。
[Abstract]:Objective to retrospectively analyze the changes of blood glucose and blood lactic acid in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Methods from January to December 2013, 58 adult patients undergoing cardiopulmonary bypass heart surgery in Xuanwu Hospital of Capital Medical University were divided into non-diabetic group and diabetic group according to whether they were complicated with diabetes before operation. According to the time of cardiopulmonary bypass, they were divided into two groups: group A (CPB time < 2 h) and group B (group B > 2 h). To observe the change trend of blood glucose and lactic acid in perioperative period and analyze the related clinical data. Results the cardiopulmonary bypass time of 58 patients was 593.15 min, mean 126.07 卤50.74 min, blocking time 35 ~ 161min, mean 67.61 卤22.95 min, automatic resuscitation rate 522.The blood glucose and blood lactic acid increased gradually after anesthesia induction. Pearson test showed that there was a positive correlation between them. Blood sugar rises to its highest level and then drops gradually. Conclusion the effect of cardiopulmonary bypass on perioperative blood glucose in patients with diabetes mellitus is more obvious. Improving the management level of CPB is beneficial to the improvement of blood glucose and lactic acid during and after operation, thus reducing postoperative complications and improving prognosis.
【作者单位】：首都医科大学宣武医院心脏中心;
【分类号】：R654.2

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