全身与硬膜外麻醉对糖尿病合并腹部手术患者围术期血糖的影响分析

Effect of General and Epidural Anesthesia on Perioperative Blood Glucose in Patients with Diabetes Mellitus Complicated with Abdominal Surgery

目的分析糖尿病合并腹部手术患者采取全身和硬膜外麻醉对围术期血糖变化的影响。方法选取2020年1月—2023年1月仙游县总医院收治的84例糖尿病合并腹部手术患者为研究对象,根据不同的麻醉方法分为对照组(42例,全身麻醉)和观察组(42例,硬膜外麻醉),比较两组围术期胰岛素使用剂量、血糖指标、血流动力学指标。结果观察组胰岛素使用剂量术后2 h、24 h血糖水平均低于对照组,差异有统计学意义(P<0.05)。观察组术中30 min、术后即刻的心率、平均动脉压水平均高于对照组,差异有统计学意义(P均<0.05)。结论糖尿病合并腹部手术患者采取硬膜外麻醉方式更有利于稳定术中体征指标,控制血糖水平,减少胰岛素使用剂量,更有利于保障手术的安全进行。

Objective To analyze the effect of general and epidural anesthesia on perioperative blood glucose changes in patients with diabetes mellitus complicated with abdominal surgery.Methods A total of 84 patients with diabetes mellitus complicated with abdominal surgery admitted to Xianyou County General Hospital from January 2020 to January 2023 were selected as the research objects.According to different anesthesia methods,they were divided into control group(42 cases,general anesthesia)and observation group(42 cases,epidural anesthesia).The perioperative insulin dosage,blood glucose index and hemodynamic index were compared between the two groups.Results The insulin dosage of the observation group and the blood glucose levels at 2 h and 24 h after operation in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).The heart rate and mean arterial pressure at 30 min during operation and immediately after operation in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Epidural anesthesia in patients with diabetes mellitus complicated with abdominal surgery is more conducive to stabilizing intraoperative signs,controlling blood glucose levels,reducing insulin dosage,and more conducive to ensuring the safety of surgery.