腹部手术后两种不同血糖控制方案对临床结果的影响

Effect of two blood glucose control protocols on the outcome of patients undergoing abdominal surgery

目的 评估腹部手术后不同血糖控制方案对临床结果的影响。方法 对2002年3月至2005年10月310例行腹部手术病例进行前瞻性对比研究。两组病例术后分别施行两种不同的血糖控制方案：传统治疗组（A组），术后血糖控制在10mmol／L以下；严格控制组（B组），术后控制血糖水平在4．4～6．1mmol／L。比较两组间在年龄、性别、生理学评分、手术侵袭度评分、体重指数、糖尿病、并发症发生率及死亡率的差异。结果对两组临床相关参数进行比较，差异无统计学意义（P〉0．05）；B组术后死亡率、并发症发生率明显低于A组（P〈0．05）。结论腹部手术后严格控制血糖能明显降低术后并发症发生率及死亡率。

Objective To evaluate the effect of two blood glucose control protocols on the outcome of patients undergoing abdominal surgery. Methods A prospective and controlled study was performed on 310 cases undergoing abdominal surgery from March 2002 to October 2005. All cases were divided into two groups based on the different blood glucose control protocols： in group A, the blood glucose level after operation was under 10 mmol/L, and in group B, the blood glucose level was between 4.4 and 6.1 mmol/L. The differences in age, sex, the physiological score, operative severity score, BMI, diabetes,morbidity and mortality were compared between the two groups. Results There was no significant differences in clinical parameters between two groups （ P 〉0.05） ,except that the mortality and incidence of complications after operation were significantly lower in group B than in group A （ P 〈 0.05 ）. Conclusion After abdominal surgery,different blood glucose control protocols influence the outcome.