不同血糖目标控制对肝胆胰术后高血糖重症患者的临床影响

Impact of different blood sugar control target on severe hyperglycemia patients after hepatobiliary and pancreatic surgery

目的 研究不同血糖目标控制对肝胆胰术后高血糖重症患者的临床影响。方法 将2014年1月-2015年1月在我院行肝胆胰外科手术的106例患者均分两组,A组、B组分别以4.5-8.3 mmol/L、7.8-10.0 mmol/L为血糖控制目标,比较两组术后24 h生化指标、血糖达标时间、血糖控制不良反应等指标。结果 A、B两组最终血糖分别控制在（6.15±1.09）mmol/L、（8.6±1.3）mmol/L,两组血糖控制时间、降钙素原和C反应蛋白水平比较,差异有统计学意义（P〈0.05）;A组低血糖及严重低血糖发生率,术后腹腔、切口、肺部感染及败血症发生率均明显高于B组。结论 7.8-10.0 mmol/L是肝胆胰术后高血糖患者血糖控制的理想目标,科学的血糖控制利于胰岛素分泌功能的恢复,有效控制血糖水平,降低血糖控制不良反应和术后并发症。

Objective To study the clinical impact of different blood sugar control target on severe hyperglycemia patients after hepatobiliary and pancreaticsurgery. Methods 106 hepatobiliary and pancreatic surgery patients from January 2014 to January 2015 of our hospital were divided into two groups.The blood sugar control target of A group and B group were respectively 4.5-8.3 mmol/L,7.8-10.0 mmol/L.24 h after operation,biochemical indexes,blood sugar thera- peutic time and adverse effect of blood sugar control in two groups were compared. Results The ultimateblood sugar in A group and B group were respectively（6.15±1.09） mmol/L and （8.6±1.3） mmol/L.The level of blood sugar control time, proealcitonin and e-reactive protein between two groups had obvious difference （P〈0.05）.The incidence rate of hypo- glycemia and severehypoglyeemia,postoperative peritoneal,incision,lung infection and sepsis in A group were obvious higher than that of B group. Conclusion 7.8-10.0 mmol/L is an ideal target for hyperglycemia patients after hepatobiliary and pancreatic surgery to control blood sugar.Science glycemic control is helpful to recover the insulin secretion function,control blood sugar effectively,reduce adverse effect of blood sugar control and postoperative complications.