2型糖尿病患者冠状动脉搭桥围手术期血糖管理

Study of blood glucose control with type 2 diabetes mellitus during perioperative period of Coronary artery bypass graft

目的:探讨冠心病合并2型糖尿病患者,行冠状动脉搭桥术围手术期,应用胰岛素泵持续皮下注射胰岛素(CSⅡ组),与甘精胰岛素加门冬胰岛素多次皮下注射(Glar组)两种治疗方法对临床指标的影响,以寻找围手术期最佳的血糖控制方案。方法:回顾性分析82例施行冠状动脉搭桥手术同时合并2型糖尿病患者的临床资料。结果:两组血糖水平均明显下降,但CSII组较Glar组血糖控制更理想、达标时间短,但两组低血糖发生率、切口愈合情况无明显差异。结论:冠心病合并2型糖尿病患者行冠状动脉搭桥术围手术期,应用胰岛素泵与甘精胰岛素两种治疗方法,都是安全有效的,在达标时间及血糖控制方面胰岛素泵更有优势。

Objective：To Study effects of CSII and Glargine on the clinical indicators in patients with type 2 diabetes mellitus（T2DM） during the perioperative period of Coronary artery bypass graft,in order to find a better way to control the blood glucose in patient with T2DM during perioperation period.Methods： Retrospective method was used to analyze the clinical data of 82 diabetic patients who receive Coronary artery bypass graft.Results： The plasma glucose level of patients in both groups dropped remarkable after the two treatments.In group CSII,the blood glucose was much lower,the time for blood glucose reaching the target was less,the hypoglycemia incidence rate and wound healing were no significant difference between the two groups.Conclusion：This study shows that CSII and Glargine both could control blood glucose effective and safe,and in group CSII the time for blood glucose reaching the target is shorter than group Glar.