中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2012年
53期
9955-9959
,共5页
血糖%血乳酸%胰岛素%体外循环%瓣膜置换
血糖%血乳痠%胰島素%體外循環%瓣膜置換
혈당%혈유산%이도소%체외순배%판막치환
背景:心脏瓣膜置换后极易发生高血糖,对患者预后不利,而围术期血糖和患者的乳酸有密切的关系.目的:观测心脏瓣膜置换患者不同时间血糖及血乳酸水平变化,并进行相关性分析.方法:将63例心脏瓣膜置换患者随机分为两组,对照组进行传统标准治疗,血糖浓度维持于7.5-11.1 mmol/L;实验组通过胰岛素持续输注进行强化治疗,血糖浓度维持于3.6-7.5 mmol/L.结果与结论:实验组患者体外循环中及瓣膜置换后血糖水平较对照组显著降低(P <0.05);两组患者随着瓣膜置换时间延长血乳酸水平都明显升高,并发生高乳酸血症,实验组并发症发生率显著低于对照组(P <0.05);两组病例都有血糖、血乳酸逐渐升高到再恢复正常的过程,尤其以置换后6 h为最高;血糖值与血乳酸值的变化趋势大致相同.通过一元线性回归分析血糖与乳酸的相关系数为0.838,单侧P <0.01,证明两个变量间有直线相关关系.结果提示,应用胰岛素严格控制血糖,对控制心脏瓣膜置换中及瓣膜置换后血糖、血乳酸水平有利,可以降低患者置换后并发症的发生率.围术期血糖与血乳酸的水平呈正相关.
揹景:心髒瓣膜置換後極易髮生高血糖,對患者預後不利,而圍術期血糖和患者的乳痠有密切的關繫.目的:觀測心髒瓣膜置換患者不同時間血糖及血乳痠水平變化,併進行相關性分析.方法:將63例心髒瓣膜置換患者隨機分為兩組,對照組進行傳統標準治療,血糖濃度維持于7.5-11.1 mmol/L;實驗組通過胰島素持續輸註進行彊化治療,血糖濃度維持于3.6-7.5 mmol/L.結果與結論:實驗組患者體外循環中及瓣膜置換後血糖水平較對照組顯著降低(P <0.05);兩組患者隨著瓣膜置換時間延長血乳痠水平都明顯升高,併髮生高乳痠血癥,實驗組併髮癥髮生率顯著低于對照組(P <0.05);兩組病例都有血糖、血乳痠逐漸升高到再恢複正常的過程,尤其以置換後6 h為最高;血糖值與血乳痠值的變化趨勢大緻相同.通過一元線性迴歸分析血糖與乳痠的相關繫數為0.838,單側P <0.01,證明兩箇變量間有直線相關關繫.結果提示,應用胰島素嚴格控製血糖,對控製心髒瓣膜置換中及瓣膜置換後血糖、血乳痠水平有利,可以降低患者置換後併髮癥的髮生率.圍術期血糖與血乳痠的水平呈正相關.
배경:심장판막치환후겁역발생고혈당,대환자예후불리,이위술기혈당화환자적유산유밀절적관계.목적:관측심장판막치환환자불동시간혈당급혈유산수평변화,병진행상관성분석.방법:장63례심장판막치환환자수궤분위량조,대조조진행전통표준치료,혈당농도유지우7.5-11.1 mmol/L;실험조통과이도소지속수주진행강화치료,혈당농도유지우3.6-7.5 mmol/L.결과여결론:실험조환자체외순배중급판막치환후혈당수평교대조조현저강저(P <0.05);량조환자수착판막치환시간연장혈유산수평도명현승고,병발생고유산혈증,실험조병발증발생솔현저저우대조조(P <0.05);량조병례도유혈당、혈유산축점승고도재회복정상적과정,우기이치환후6 h위최고;혈당치여혈유산치적변화추세대치상동.통과일원선성회귀분석혈당여유산적상관계수위0.838,단측P <0.01,증명량개변량간유직선상관관계.결과제시,응용이도소엄격공제혈당,대공제심장판막치환중급판막치환후혈당、혈유산수평유리,가이강저환자치환후병발증적발생솔.위술기혈당여혈유산적수평정정상관.
BACKGROUND: Hyperglycemia after cardiac-valve replacement can happen easily that is unfavorable on the prognosis. However, the perioperative blood glucose has close relationship with the level of lactic acid in patients. OBJECTIVE: To observe the changes of blood glucose and blood lactic acid levels in the patients with cardiac-valve replacement, and to perform the correlation analysis. METHODS: Sixty-three patients with cardiac-valve replacement were randomly divided into two groups. The control group received traditional standard therapy, and the blood glucose concentration was maintained at 7.5-11.1 mmol/L. The experimental group received intensive therapy by subcutaneous infusion or continuous insulin infusion, and the blood glucose concentration was maintained at 3.6-7.5 mmol/L. RESULTS AND CONCLUSION: The concentration of blood glucose during cardiopulmonary bypass and after valve replacement in experimental group was lower than that in the control group (P < 0.05); with the time of the cardiac-valve replacement increased, the blood lactic acid levels of two groups were significantly increased, and the hyperlactacidemia could be seen, the incidence of complications in the experimental group was lower than that in the control group (P <0.05). The blood glucose and blood lactic acid levels in two groups were gradual y increased and returned to the normal levels, the blood glucose and blood lactic acid levels were highest at 6 hours after replacement. The changes of blood glucose level and blood lactic acid level were the same. One variant linear regression analysis showed the correlation coefficient of blood glucose and lactic acid was 0.838 and P < 0.01 in one side, which proved that there was a linear relationship between the two variables. Strict application of insulin is beneficial to the control intraoperative and postoperative blood glucose and blood lactic acid levels of cardiac-valve replacement and can reduce the incidence of complication after replacement. Perioperative blood glucose and blood lactic acid levels are positively correlated.
