心脏不停跳、停跳二尖瓣置换术患者围术期血糖、胰岛素变化对比观察

A clinical study on variation of the blood glucose and insulin in patients undergoing beating heart or cardiac arrest MVR

目的观察心脏不停跳、停跳二尖瓣置换术患者围手术期血糖及胰岛素变化。方法将24例因二尖瓣病变体外循环下行瓣膜置换术的成年患者随机分为为中低温停跳组(停跳组)和浅低温不停跳组(不停跳组)各12例。观察两组转流前、转流中(转流0.5 h)、停机后(停机即刻、4 h、24 h)抽取非输液肢体静脉血测血糖和血清胰岛素水平变化。结果两组者转流中、转流后各时点血糖、血清胰岛素水平均高于转流前(P均<0.05)。转流中、转流后各时点不停跳组血糖、血清胰岛素水平低于停跳组(P均<0.05)。结论浅低温不停跳手术对患者围术期血糖及血清胰岛素水平影响较小。

Objective To observe the variation of the blood glucose and insulin during the perioperative period in patients undergoing beating heart or cardiac arrest mitral valve replacement （MVR）. Methods A total of 24 patients undergoing MVR were randomly divided into cardiac arrest group and beating heart group. Blood concentrations of glucose and insulin were measured before extracorporeal circulation, after extracorporeal circulation 0.5h, extracorporeal circulation stop, 4 h and 24 h of the operation. Results Compared with before extracorporeal circulation,the levels of blood glucose and insulin at the time of after extracorporeal circulation and extracorporeal circulation stop increased significantly. And it was higher in cardiac arrest group than that of beating heart group. Conclusion The beating heart mitral valve replacement has little effect on the levels of blood glucose and insulin in patients during the perioperative period.