玻璃体切割手术对糖尿病患者血糖的影响

The effect of vitrectomy on blood sugar in diabetic patients

目的 评价糖尿病患者玻璃体切割手术后血糖变化 ,并分析有关影响因素。 方法 选择接受玻璃体切割手术的II型糖尿病患者 19例 ,测定术前、术后 1～ 2h、1、3、5d空腹血糖。用方差分析、t检验和相关回归分析方法分析术后血糖变化及其与术前基础血糖水平、糖尿病病程、手术时间及术中强化麻醉的相关性。 结果 糖尿病患者玻璃体切割手术后血糖显著高于术前 ,术后 1～ 2h达高峰 ,后逐渐下降(P <0 .0 5 ) ,至 5d基本接近术前水平 (P >0 .0 5 )。血糖升高与手术时间、术前基础血糖水平及糖尿病病程呈正相关 (P <0 .0 5 ) ,与术中强化麻醉有关。 结论 糖尿病患者玻璃体切割手术后血糖变化存在着先升高 ,至 5d左右趋于术前水平的规律。术后血糖变化主要影响因素为术前基础血糖水平、糖尿病病程、手术时间及术中强化麻醉。

Objective To evaluate the change of blood sugar in diabetic patients after vitrectomy and analyze the relative reasons. Methods Nineteen diabetes II patients (20 eyes) who underwent vitrectomies received the tests of blood sugar preoperatively, and 1～2 hours, 1, 3, and 5 days postoperatively. Analysis of variance, a paired Student's t-test, and correlation analysis were used to analyze the change of postoperative blood sugar and correlation between postoperative blood sugar change and its relative factors. Results Postoperative blood sugar increased significantly compared with the preoperative one (P< 0.05), reached the peak 1～2 hours postoperatively, and reached almost the preoperative level 5 days postoperatively (P>0.05). There was a positive correlation between blood sugar increase and operation time, preoperative blood sugar level, and diabetic duration (P<0.05). Postoperative blood sugar was relative to potentiated anesthesia. Conclusion There is a regularity that blood sugar increases just postoperatively and reaches the preoperative level 5 days postoperatively. The relative factors to blood sugar change include preoperative blood sugar level, diabetic duration, operation time, and potentiated anesthesia.