张瑞娟

[摘要] 目的 分析糖尿病患者外科手术麻醉方式。 方法 随机抽取该院于2016年5月—2017年8月收治的103例糖尿病患者为研究对象。所有患者均行外科手术治疗。根据麻醉方法的不同，将其分成对照组（56例）和观察组（47例）。分别给予两组患者常规气管插管全麻、硬膜外麻醉。观察患者的麻醉生效时间、麻醉清醒时间、并发症发生率（糖尿病酮症酸中毒、糖尿病高渗性非酮症昏迷、低血糖）以及血糖指标变化（入手术室、切皮时、离开手术室前）。结果 观察组患者的麻醉生效时间、麻醉清醒时间均短于对照组患者，差异有统计学意义（P<0.05）；两组并发症发生率及血糖指标均差异无统计学意义（P>0.05），但切皮时、离开手术室前，对照组血糖指标升高幅度高于观察组患者。 结论 与气管插管全麻相比，硬膜外麻醉更适用于糖尿病外科手术患者，这种麻醉方式的麻醉效果好，有利于维持患者血糖指标的稳定。

[关键词] 糖尿病；手术治疗；麻醉

[中图分类号] R59 [文献标识码] A [文章编号] 1672-4062（2018）02（a）-0025-02

Clinical Study on Surgical Anesthesia in Diabetic Patients

ZHANG Rui-juan

Department of Anesthesiology， Fuzhou Second Hospital Affiliated to Xiamen University， Fuzhou， Fujian Province， 350007 China

[Abstract] Objective To analyze the surgical anesthesia of diabetic patients. Methods 103 cases of diabetes patients treated in our hospital from May 2016 to August 2017 were selected and randomly divided into two groups， according to the different methods of anesthesia， including the control group （56 cases） and the observation group （47 cases）， and two groups of patients were given general anesthesia and epidural anesthesia for routine tracheal intubation. And the anesthesia entry-into-force time， anesthesia awakening time， incidence of complications （diabetic ketoacidosis， hyperosmolar nonketotic diabetic coma， low blood glucose） and blood glucose index changes （entering the operation room， at skin incision and leaving the operation room） were observed. Results anesthesia entry-into-force effect time， anesthesia awakening time in the observation group were shorter than those in the control group， and the differences were statistically significant （P<0.05）； the differences in the incidence rate of complications and blood glucose between the two groups were not statistically significant（P>0.05）， but the increase range of blood glucose at skin incision and before leaving the operation room in the control group was higher than that of patients in the observation group. Conclusion Compared with endotracheal intubation general anesthesia， epidural anesthesia is more suitable for patients with diabetic surgical operation. This anesthesia mode has good anesthetic effect and is beneficial to maintaining the stability of blood glucose index in patients.

[Key words] Diabetes； Surgical treatment； Anesthesia

作為一种临床常见病之一，高血糖是糖尿病的基本特征。发病后，患者在长期高血糖水平的影响下，肾脏、血管、神经等均会受到不同程度的损害，诱发大隐静脉曲张等疾病[1]。外科手术治疗期间，糖尿病患者发生低血糖、糖尿病高渗性非酮症昏迷等并发症的风险较高。为了对比气管插管全麻与硬膜外麻醉的应用效果，该文以2016年5月—2017年8月收治的103例糖尿病患者为研究对象，现将麻醉流程分析如下。

1 资料与方法

1.1 一般资料

随机抽取该院收治的103例糖尿病患者为研究对象。……