手术时长对老年非糖尿病手术病人术中血糖异常的影响及预测价值

Influence and predictive value of operation duration on abnormal blood glucose in elderly non-diabetic patients receiving surgery

目的探索手术时长对老年非糖尿病手术病人术中血糖异常的预测价值。方法以首都医科大学宣武医院2021年5~8月307例老年手术病人为研究对象。术前建立动脉导管测量术中血糖水平,术中动脉血糖正常水平为4.2~6.4 mmol/L。采用SPSS 24.0软件对数据进行统计分析,采用二元Logistic回归分析手术时长与老年非糖尿病手术病人术中血糖异常的相关性,并绘制ROC曲线,计算AUC评估手术时长对血糖异常的预测能力。结果最终纳入200例老年非糖尿病手术病人,调整了重要混杂因素后,手术时长>4 h与术中血糖异常呈显著相关性(OR=8.983,95%CI:2.953~27.320,P<0.001)。手术时长预测术中血糖异常的AUC为0.819,灵敏度为0.735,特异度为0.774。结论手术时长>4 h的老年非糖尿病手术病人术中血糖异常的风险增高,手术时长对老年非糖尿病手术病人术中血糖异常的预测价值较好,提示需要加强老年非糖尿病手术病人的血糖管理,提高对术中血糖异常的认识和管理。

Objective To explore the predictive value of operation duration for the abnormal blood glucose in the elderly non-diabetic patients receiving surgery.Methods The data of 307 elderly patients receiving surgery from May to August 2021 in Xuanwu Hospital of Capital Medical University was analyzed.An arterial catheter was established before the operation to measure the blood glucose level during the operation.The arterial blood glucose during operation ranging from 4.2~6.4 mmol/L was defined as normal blood glucose.SPSS 24.0 software was used to analyze the data.Logistic regression analysis was used to analyze the correlation between operation time and abnormal blood glucose in the elderly non-diabetic patients receiving surgery,and the area under the receiver operating characteristic curve(AUC)was used to evaluate the predictive ability.Results A total of 200 elderly non-diabetic patients receiving surgery were enrolled.After adjusting for important confounding factors,the operation duration>4 h was significantly correlated with intraoperative blood glucose abnormalities(OR=8.983,95%CI:2.953-27.320,P<0.001).The AUC for predicting abnormal blood glucose during operation was 0.819,with a sensitivity of 0.735,and a specificity of 0.774.Conclusions The operation time has a better predictive value for abnormal blood glucose during surgery in the elderly non-diabetic patients receiving surgery.It is important to improve the awareness and management of intraoperative blood glucose abnormalities.