胡海红，叶建虹，黄永刚

(浙江医院，浙江 杭州 310013)

·基础与临床研究·

强化降血糖治疗对老年糖尿病患者围手术期血糖控制的影响

胡海红，叶建虹，黄永刚

(浙江医院，浙江 杭州 310013)

目的：探讨强化降血糖治疗与一般性降糖治疗对老年糖尿病患者围手术期血糖控制的影响。方法选取2012年6月至2014年10月在本院接受胃肠道择期手术合并2型糖尿病患者96例作为研究对象，术后均常规禁食并全胃肠外营养。按手术时间的先后顺序编号随机分成2组，各48例，治疗组采取强化降血糖治疗，对照组采用一般性降血糖治疗。结果2组患者围手术期低血糖发生率分别为6.25%、8.33%，差异无统计学意义(P>0.05)。治疗组患者术后并发症的发生率明显低于对照组，差异有统计学意义(P<0.05)。结论采取强化降血糖治疗可显著降低糖尿病患者围手术期的术后并发症，有助于患者术后的康复。

糖尿病；血糖；围手术期；强化降血糖

Abstract： [Objective] To compare the effect of intensified blood sugar (BG) control approach and normal BG control approach in peri-operational BG control of elder diabetic patients. [Method] 96 cases of elder diabetic patients who had undergone gastrointestinal surgery during 2012-6 to 2014-10 was selected as the study object. All of these patients was given fasting diet and total parenteral nutrition (TPN) after surgery. Patients was numbered by surgery date and divided into two groups randomly with 48 cases each. The clinical intervention strategy for therapy group was intensified BG control approach and normal BG control approach for control group. [Result] Two groups turn out to have similar incidence of hypoglycemia, with therapy group 6.25% and control group 8.33%,which has no significant difference(P>0.05). While therapy group had lower post-operation complication incidence than control group, which has significant difference(P<0.05). [Conclusion] Intensified BG control approach could lower the post-operation complication incidence of diabetic patients, and conduce to patients’ post-operation recovery.

Keywords: diabetes; blood sugar; perioperative; intensive blood glucose lowering

糖尿病是常见的内分泌疾病之一，目前糖尿病患者约占外科手术住院患者的20%[1]。糖尿病患者易发感染，常伴有心血管、肾脏及神经系统疾病，其手术的风险性较非糖尿病患者高，术后感染率也较非糖尿病患者高10倍左右[2-3]。目前越来越多的合并有糖尿病的患者接受胃肠外科手术治疗。如何让这些患者安全渡过围手术期，寻求糖尿病患者围手术期血糖监测的最佳方式以及由此制定良好、有效的干预治疗策施，是临床迫切需要解决的问题。本研究对行胃肠道手术的2型糖尿病患者围手术期采取不同的血糖监控治疗方法，探讨如何更好地控制血糖，减少术后并发症的发生。