心内直视手术109例CPB期间血糖变化的临床分析

The Clinical Analysis of 109 Case's Blood Glucose Changes with Open Heart Surgery during CPB

目的初步分析心内直视手术患者在体外循环期间血糖变化规律及其影响因素。方法选择择期行心内直视手术患者109例,采集每一位患者体外循环前(t0),体外循环转流45min(t1),体外循环结束时(t2)三个时间点的静脉血并测定血糖值。将109例患者按体外循环时间是否大于1h和年龄是否大于18岁分组。结果全组患者血糖在体外循环期间逐渐升高,停机时血糖浓度达到高峰,停机时的血糖浓度与体外循环时间成正相关。成年人和未成年人在体外循环期间的血糖浓度差异有统计学意义,未成年人的血糖浓度明显高于成年人。对于成年人体外循环时间>1h的患者停机时刻的血糖浓度明显高于体外循环时间<1h的患者。结论心内直视手术患者在体外循环期间的血糖浓度较术前明显升高;并且停机时刻血糖浓度与体外循环时间呈正相关,未成年人较成年人体外循环期间的血糖浓度升高更明显;体外循环时间>1h的成人患者停机时血糖浓度较<1h者明显升高,值得关注。

Objective To priliminarily analyze the changes of blood glucose during CPB and its influencing on patients undergoing open heart surgery.Methods 109 patients who undergoing open heart surgery were selected.Every patient＇s blood glucose samples were taken before CPB（t0）,CPB 45 mins（t1）,the end of CPB（t2）.The patients was divided into 8 groups according to whether the age was greater than 18-year-old and whether the CPB time was longer than 1h.Results Blood glucose in all patients gradually increased during CPB,when ending CPB the concentration reached a peak parking,and blood glucose level at the end time and CPB time had a positive correlation.The blood glucose concentration of the two groups who aged above 18 years and below 18 years had significant difference（P0.05）.For the patients aged over 18 years,the blood glucose concentration had a positive correlation between the patients whether the CPB time was longer than 1h（P0.05）.Conclusion The blood glucose concentration of patients undergoing open heart surgery increase gradually and the blood glucose concentration of the time of stopping CPB and the CPB time have positive correlate.The changes of blood glucose concentration in patients above age 18 are greater than those in patients below age 18.For the patients above age 18,the blood glucose concentration of the patients whose CPB time is more than 1h at the end time of CPB are significantly higher than those of patients whose CPB time is shorter than 1h.