糖尿病患者体外循环心脏手术后早期脑损伤的临床研究

Clinical study of the brain injuries at early period after open heart surgery by cardiopulmonary bypass in diabetes patients

目的 探讨糖尿病患者行体外循环心脏手术后早期脑损伤的情况。方法 随机选择行瓣膜置换术的糖尿病患者 16例为实验组 ,非糖尿病患者 2 0例为对照组。在体外循环结束后 5小时抽血 ,采用 EL ISA法检测血清 S10 0 B蛋白浓度 ,以判断脑损伤的发生。结果 实验组和对照组的术后早期脑损伤发生率分别为 94 %和6 5 % ,有显著性差异 (P<0 .0 5 )。结论 糖尿病患者在体外循环术后脑损伤的发生率明显高于非糖尿病患者。为减少糖尿病患者术后脑损伤的发生 ,术前必须严格控制血糖 ,术中严密观察血糖变化 ,术中和术后及时应用胰岛素控制血糖。

Objective To study the brain injuries at early period after open heart surgery by cardiopulmonary bypass(CPB) in diabetes patients.Methods 16 diabetes patients undergoing valvular heart disease were selected randomly as experimental group,20 non-diabetes patients were selected randomly as control group.At 5 hours after CPB termination,blood of all cases were taken,and the blood serum levels of S100B were assayed by enzyme-linked immuno sorbent assay(ELISA).Result Incidence of brain injuries at early period after open heart surgery in diabetes patients and non-diabetes patients were 94% and 65% respectively(P<0.05).Conclusion Incidence of brain injuries at early period after open heart surgery in diabetes patients is significantly higher than that in non-diabetes patients.To reduce incidence of brain injuries after open heart surgery in diabetes patients,we must control preoperative blood sugar,observing exactly changes of blood sugar during operation,using insulin in time to control blood sugar during and after operation.