硬膜外麻醉和全身麻醉对2型糖尿病患者围手术期血糖的影响

摘要

目的：总结分析硬膜外麻醉和全身麻醉对2型糖尿病患者围手术期血糖的影响。方法随机选取该院2014年2月1日-2015年1月1日期间的2型糖尿病患者围手术期患者，其中，30例接受全身麻醉的患者被设为对照组，30例接受硬膜外麻醉的患者被设为试验组，观察、比较两组患者的血糖情况。结果试验组手术切皮充CO2气腹时、手术结束时的血糖(8.5±1.5) mmol/L、(8.2±2.2) mmol/L均优于对照组(12.4±2.5) mmol/L、(11.5±2.3) mmol/L，差异具有统计学意义(P<0.05)；试验组手术后3 h、23 h血糖(13.3±2.3)mmol/L、(12.5±2.5)mmol/L均优于对照组(15.4±5.4)mmol/L、(16.3±2.9)mmol/L，试验组胰岛素用量(20.2±4.2)U优于对照组(27.1±6.3)U，差异均具有统计学意义(P<0.05)。结论2型糖尿病经硬膜外麻醉的围手术期血糖情况显著优于全身麻醉，减少胰岛素用量，可考虑于临床中合理推广。%Objective To summarize and analyze the effects of epidural anesthesia and general anesthesia on the periopera-tive blood glucose level in patients with type 2 diabetes. Methods 30 type 2 diabetes patients underwent surgery with gen-eral anesthesia and other 30 type 2 diabetes patients underwent surgery with epidural anesthesia in our hospital from February 1, 2014 to January 1, 2015 were randomly selected as the control group, and the experimental group, respectively. And the perioperative blood glucose level of the two groups was observed and compared. Results During the period of cut-ting skin for pneumoperitoneum via CO2 insufflation tubing, the blood glucose level was significantly lower in the experi-mental group than that in the control group[(8.5±1.5) vs (12.4±2.5)] mmol/L, P<0.05. At the end of surgery, the blood glucose level was significantly lower in the experimental group than that in the control group[(8.2±2.2) vs (11.5±2.3)] mmol/L, P<0.05. Compared with the control group, 3h after surgery, the blood glucose level was much lower in the experimental group[(13.3±2.3) vs (15.4±5.4)] mmol/L, P<0.05. 23h after surgery, the blood glucose level was much lower in the experimental group than that in the control group[(12.5±2.5) vs (16.3±2.9)] mmol/L, P<0.05. Compared with the control group, the insulin dosage was much less in the experimental group than in the control group[(20.2±4.2) vs (27.1±6.3)]U with statistically significant differ-ence, P<0.05. Conclusion The perioperative blood glucose level was much better and the dosage of insulin was obvious less in type 2 diabetes patients with epidural anesthesia than those with general anesthesia, so epidural anesthesia can be pro-moted reasonably in clinical practice.