实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (5): 433-436.doi: 10.3969/j.issn.1003-9198.2022.05.001

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老年糖尿病病人应激性高血糖与胸腔镜下肺切除术后肺部并发症的关系

陈紫璇, Sara Musa Abdalla Elamin, 朱琳佳, 查天明, 许斯洋, 桂波, 张扬   

  1. 210029 江苏省南京市,南京医科大学第一附属医院麻醉与围术期医学科(陈紫璇,Sara Musa Abdalla Elamin,朱琳佳,查天明,张扬);
    210024 江苏省南京市,江苏省省级机关医院麻醉科(许斯洋,桂波)
  • 收稿日期:2022-03-05 出版日期:2022-05-20 发布日期:2022-05-26
  • 通讯作者: 张扬,Email:young1142@163.com
  • 作者简介:张扬 住院医师

Relationship between stress hyperglycemia and postoperative pulmonary complications after thoracoscopic lung resection in elderly patients with diabetes mellitus

CHEN Zi-xuan, Sara Musa Abdalla Elamin, ZHU Lin-jia, ZHA Tian-ming, XU Si-yang, GUI Bo, ZHANG Yang   

  1. CHEN Zi-xuan, Sara Musa Abdalla Elamin, ZHU Lin-jia, ZHA Tian-ming, ZHANG Yang. Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China;
    XU Si-yang, GUI Bo. Department of Anesthesiology, Jiangsu Province Official Hospital, Nanjing 210024, China
  • Received:2022-03-05 Online:2022-05-20 Published:2022-05-26

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摘要： 目的 探讨老年糖尿病病人应激性高血糖(stress hyperglycemia, SH)与胸腔镜下肺切除术后肺部并发症(postoperative pulmonary complications, PPCs)的关系。 方法 回顾性选择2017年1月至2020年7月在我院行择期胸腔镜下肺切除术的老年糖尿病病人367例,收集病人一般资料、合并症、医师组别、术中液体出入量、手术时长及肌酐、Hb、白细胞、HbA1c、血糖水平等。采用应激性高血糖比率(stress hyperglycemia ratio, SHR)评估SH强度。采用多因素Logistic回归分析病人发生PPCs的危险因素。 结果 162例(44.1%)老年糖尿病病人发生PPCs(并发症组)。与无并发症组相比,并发症组病人入院时FPG、术日动脉FPG水平以及入院时SHR显著升高(P＜0. 05)。多因素Logistic回归分析显示,术日动脉FPG水平与入院时SHR是老年糖尿病病人胸腔镜下肺切除术后发生PPCs的独立危险因素。 结论 术日动脉FPG水平以及入院时SHR是老年糖尿病病人胸腔镜下肺切除术后发生PPCs的独立危险因素。

关键词: 老年人, 糖尿病, 应激性高血糖, 胸腔镜下肺切除术, 肺部并发症

Abstract: Objective To investigate the relationship between stress hyperglycemia (SH) and postoperative pulmonary complications (PPCs) after thoracoscopic lung resection in the elderly patients with diabetes mellitus(DM). Methods A total of 367 elderly DM patients who underwent elective thoracoscopic lung resection in our hospital from January 2017 to July 2020 were enrolled. The data of clinical features, comorbidities, surgeons, intraoperative volume of liquid, duration of operation, levels of creatinine, hemoglobin, white blood cells, glycosylated hemoglobin and blood glucose were collected. Stress hyperglycemia ratio (SHR) was used to assess the intensity of SH. Multivariate Logistic regression analysis was used to analyze the risk factors for PPCs in the elderly patients with DM. Results Among the 367 elderly DM patients, 162 cases (44.1%,complication group) presented with PPCs. There were significant differences in serum fasting plasma glucose(FPG) at admission, preoperative arteria FPG, and SHR at admission between the two groups (all P＜0. 05). Multivariate Logistic regression analysis showed that preoperative FPG and SHR at admission were the independent risk factors of PPCs in the elderly patients with DM. Conclusions The levels of preoperative arterial FPG and SHR at admission show significant effects on the incidence of PPCs in the elderly patients with DM after thoracoscopic lung resection.

Key words: aged, diabetes, stress hyperglycemia, thoracoscopic lung resection, pulmonary complications

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