髋部骨折并糖尿病患者围手术期血糖水平对预后影响

Hip Fracture Patients with Diabetes and Perioperative Blood Glucose Levels on Prognosis

目的探讨髋部骨折并糖尿病患者围手术期血糖水平,分析其对患者预后影响。方法选择82例髋部骨折并糖尿病患者,其中空腹血糖控制良好组(A组),空腹血糖控制不良组(B组),术前血红蛋白水平比较,A组低于B组(P<0.05)。比较A、B两组患者术前等待时间、住院时间、手术至切口拆线时间、并发症发生率,并比较两组术后1年死亡率、患者户外活动能力恢复情况等。结果平均随访时间13.6个月,A、B两组住院时间、手术至切口拆线时间差异无统计学意义(P>0.05),术前等待时间比较,A组较B组缩短,A组并发症发生率低于B组,术后A组1个月无患者死亡,死亡率低于B组,以上比较均差异有统计学意义(P<0.05),术后1年死亡率比较,A、B两组差异无统计学意义(P>0.05)。结论在髋部骨折并糖尿病围手术期治疗中,血糖水平高会影响患者的预后,造成不良影响,在围手术期需要控制血糖水平,从而降低并发症发生率及意外事件,在临床有重要意义。

Objective To explore hip fracture patients with diabetes and perioperative blood glucose levels, analyze the prognosis of the patient.Methods To choose 82 cases of hip fractures and diabetes, in which the fasting blood glucose is well controlled group （A）, fasting blood glucose poor control group （group B）, compare the preoperative hemoglobin level, A group than that in group B （P〈0.05）. Comparative A, B before the two groups of patients waiting for surgery time, hospital stay, surgical incision stitches to time, complication rates, and compared the two groups after 1-year mortality, patient re- covery and other outdoor activity. Results The average time of 13.6 months of follow-up, A, B two hospital stays, surgical stitches to cut the time difference was not significant, statistically insignificant （P〉0.05）, preoperative waiting time compari- son, A group shorter than that in group B, A group the complication rate is lower than group B, group a after 1 month no patients died, the mortality rate is lower than group B, the above comparisons are significantly different, statistically signifi- cant （P〈0.05）, after 1-year mortality rate, A, B two groups was statistically insignificant （P〉0.05）. Conclusion In hip frac- ture and perioperative treatment of diabetes, high blood glucose levels can affect the prognosis of patients with adverse effects in the perioperative period is necessary to control blood sugar levels, thereby reducing the incidence of complications and accidents, the clinical significance.