心脏搭桥术对糖尿病人降糖治疗方案的影响

目的 :通过观察 型糖尿病 (DM- )行心脏冠脉搭桥术 (CABG)术后血糖水平的升高到恢复至术前状态的过程 ,从而判断 CABG对 DM- 降糖治疗的影响。方法 :选择 36例 DM- 合并冠心病病人 ,均于体外循环 (CPB)下行心脏搭桥术 ,从术前监测血糖 ,直至术后第七天 ,于术中及术后根据血糖水平适当应用胰岛素 ,观察其对降糖治疗效果及血糖趋于稳定的过程 ,从而判断 CABG对 DM- 血糖的影响。结果 :术中及术后 1～ 3d血糖会较术前明显升高 ,需加用胰岛素助降糖 ,术后 3d血糖渐降 ,第六天趋于稳定 ,第七天恢复至接近术前水平。结论 :DM- ,病人行 CABG术 ,只要围术期有效控制血糖 ,术后血糖基本会逐渐恢复至术前状态 ,对其今后的降糖治疗不会造成严重影响

Effect of Artery Coronary Bypass Grafting on Lowering Blood Sugar Level of Diabetics

Objective To find out the effect of artery coronary bypass grafting (CABG) on lowering blood sugar level of diabetics by observing the variations between postoperative rise from and recovery to the original blood sugar level of the patients with diabetes mellitus Ⅱ (DM Ⅱ) who had undergone CABG. Methods Monitoring the blood sugar level of 36 patients with DM Ⅱ complicating coronary heart disease, who had undergone CABG under extracorporeal circulation, was carried out before surgery till the seventh day after operation. Proper doses of insulin were administrated during and after operation based on the blood sugar level of the patients. Observation was made on the effect of hypoglycemic therapy and on the process in which the patients' blood sugar level was levelling off, thus determining the effect of CABG on lowering the blood sugar level of the diabetics. Results An obviously higher blood sugar level was seen during operation and 1 to 3 days after operation than before operation. In this case, insulin was needed to lower blood sugar level. As a result, after surgery the blood sugar level began to reduce on the third day, it levelled off on the sixth day, and on the seventh day it returned closely to that before surgery. Conclusion For DM Ⅱ patients, CABG causes no severe outcome of on going treatment of lowering blood sugar level, which can be gradually restored approximately to the level before operation, so long as blood sugar level is efficiently controlled before, during and after operation.