老年糖尿病患者髋关节置换手术围手术期处理

Perioperative management of hip arthroplasty in elderly patients with diabetes mellitus

目的探讨老年糖尿病患者髋关节置换手术围手术期血糖的控制方法和对手术的影响。方法回顾性分析32例老年糖尿病髋关节置换手术治疗围手术期血糖调控情况。结果32例患者入院时空腹血糖(12.8±1.7)mmol/L,经术前用胰岛素控制空腹血糖至(7.1±1.2)mmol/L后,分别接受全髋关节置换、股骨头置换手术,术中及术后继续使用胰岛素控制血糖至基本正常水平。本组术中血糖为(8.9±1.1)mmol/L。32例中,仅1例(3.2%)伤口愈合不良,未发生感染等其他明显并发症。结论老年糖尿病患者经正确的围手术期处理,将血糖控制至基本正常水平,可耐受髋关节置换手术。

Objective To evaluate the perioperative blood glucose control on and hip arthroplasty results in the old patients with diabetes mellitus. Methods The blood glucose control during perioperative period in 32 patients with diabetes mellitus who had accepted the hemiarthroplasty and total hip arthroplasty were analysed retrospectively. Results The average fasting blood glucose level of 32 cases on admission was （ 12.8 ± 1.7 ） mmol/L and was controlled to （7.1 ± 1.2）mmol/L with insulin before operation. Insulin was kept on being used during operation and postoperation. Delayed wound healing occurred only in one of the 32 cases. No other complications occurred. Conclusion The old patients with diabetes mellitus can accept hemiarthroplasty and total hip arthroplasty after controlling the blood glucose level with insulin properly.