静脉输注温热液体对双侧人工关节置换术患者血糖的影响

目的探讨静脉输注温热液体对双侧人工关节置换术患者血糖的影响。方法选取行双侧关节置换术患者,随机分为温热组和常温组。温热组患者44例,术中静脉输入温度为36.5～37.5℃的温热液体及库存血,并采用37℃恒温冲洗液进行术区冲洗;常温组患者44例,术中静脉输入备于手术室（室温为22～24℃）的常温液体及库存血,并用常温冲洗液进行术区冲洗。观察两组患者血糖浓度在术中各观察时间点的变化。结果随着手术进程,两组患者血糖增长趋势略有不同;温热组患者血糖浓度略低于常温组,但差异无统计学意义（P〉0.05）;温热组患者高血糖发生率在术中2h、3h及术毕即刻均低于常温组,差异有统计学意义（P〈0.05）。结论术中应用温热液体静脉输注可缓解双侧人工关节置换术患者应激性血糖的升高,且可能对减缓机体应激反应有一定的作用。

Effects of Warmer Fluids of Intravenous Infusion on Serum Glucose of Patients Undergoing Bilateral Prosthetic Replacement of Joints

Objective To explore the effect of warm fluid of intravenous infusion on serum glucose of patients undergoing bilateral prosthetic replacement of joints.Methods Patients with bilateral prosthetic replacement of joints were divided into the warm group and the normal temperature group randomly.Forty-four patients in the warm group were infused with fluids and banked blood（36.5-37.5 ℃）and flushed with fluid（37 ℃）.While forty-four patients in the normal temperature group were infused and flushed with fluid and banked blood（22-24 ℃）.The changes of serum glucose in different operative phases were observed.Results The trend growth of serum glucose of both groups differed slightly with advances in operative procedures.The blood sugar concentration of the warm group was lower than that of the normal temperature group without statistical significance（P0.05）.The incidence of hyperglycemia of the normal temperature group was higher than that of the warm group at 2,3h during operation and the moment after operation（P0.05）.Conclusion Warm fluids of intravenous infusion applied to patients undergoing bilateral prosthetic replacement of joints intraoperatively can relieve stress-induced hyperglycemia,and may have some effects on slowing down the extent of immunological stress reaction.