术中库血输注对脊柱手术患者血糖的影响

Effect of banked blood transfusion on the blood glucose levels in patients undergoing orthopedic surgery

目的研究术中库血输注对脊柱手术患者血糖的影响。方法随机选择32例脊柱侧凸后路矫形术患者作为输血组(A组),20例脊柱侧凸前路松解术患者作为非输血组(B组)。输血组均确定在手术开始2h后开始输血。记录麻醉诱导后(Ta)、手术开始即刻(T0)、手术1h(T1)、2h(T2)、3h(T3)、4h(T4)、5h(T5)7个时间点静脉血血糖值。所输库血为枸橼酸磷酸盐葡萄糖(CPD)-红细胞悬液,存储时间为(10.0±5.6)d,血糖值为(19.8±5.3)mmol/L。结果(1)Ta至T2期间,两组患者血糖的变化呈逐渐上升趋势,T2至T5期间,B组血糖趋于平稳,A组的血糖进一步升高。(2)A组患者中,有21例(65.6%)输血后即刻血糖值超过了6.4mmol/L,7例(21.9%)输血后即刻血糖值超过了7.8mmol/L。结论术中输注库血可以引起患者血糖的升高。

Objective To investigate the effect of banked blood transfusion on the blood glucose levels. Methods Thirty-two patients undergoing selective posterior correction surgery for scoliosis were randomly enrolled as group A （transfusion） and twenty patients undergoing selective anterior release surgery for scoliosis as group B （non-transfusion）. Blood glucose levels were monitored after induction of the anesthesia（Ta ）, at the beginning of operation（T0 ） and 1 h（T1 ）, 2 h（T2 ）, 3 h（T3 ） ,4 h （T4） and 5 h（T5 ） during surgery. The time of banked packed RBC （preserved with CPD） storage was （10±5.6） days,which contained dextrose of （19.8±5.32） mmol/L. Results （1） The blood glucose levels in two groups increased gradually from Ta to T2 ,which were not makedly changed from T2 to T5 in group B but increased continuously in group A. （2） In group A, the blood glucose level greater than 6.4 mmol/L shortly after transfusion was seen in 21 patients （65.6%） and greater than 7.8 mmol/L in 7 patients （21.9%）. Conclusion Transfusion of banked blood can cause an increase of blood glucose in patients during orthopedic surgery.