胸部手术患者应激性高血糖对预后的影响及其意义

目的探讨胸部手术后应激性高血糖与术后发生并发症的关系。方法对90例符合入选标准行胸部手术非糖尿病患者的资料进行回顾性分析,依照术后血糖值分为3组A组血糖值为3.9～6.10mmol/L;B组6.11～12.22mmol/L;C组>12.22mmol/L。观察3组患者术后伤口、泌尿系及肺部感染、脏器功能衰竭及病死率情况。结果随着血糖值的逐渐升高,患者手术后各种并发症显著增加(P<0.05),且呈正相关,相关系数r分别为0.977、0.984、0.977、0.872、0.864。结论应激性高血糖可能是胸部手术后各种并发症的主要原因之一。因此,加强术后监护及血糖控制,可减少各种并发症的发生。

Prognostic value of stress hyperglycemia in patients after thoracic surgery

Objective To investigate the relationship between thoracic postoperative hyperglycemia and the postoperative complications.Methods 90 cases of non diabetic patients undergoing thoracic operation were studied retrospectively.They were divided into 3 groups according to their post operative blood glucose levels: blood glucose value in group A ranged from 3.9 mmol/L to 6.10 mmol/L,in group B ranged from 6.11mmol/L to 12.22 mmol/L,while in group C was above 12.22mmol/L.Indexes including post operative wound infection,urinary system infection,pulmonary infection,organs function failure and case fatality rate were observed.Results With increasing of the blood glucose concentration,the complications were significantly elevated(P<0.05),with positive correlation (r=0.977,0.984,0.977,0.872 and 0.864 respectively).Conclusion Stress hyperglycemia is one of the major causes of complications in thoracic postoperative patients,so postoperative intensive care should be strengthened and blood glucose should be controlled so as to reduce complications.