老年2型糖尿病患者急诊手术麻醉管理临床研究.docVIP

老年2型糖尿病患者急诊手术麻醉管理临床研究 　　摘要：目的 研究老年2型糖尿病患者急诊手术麻醉管理，总结急诊糖尿病病人麻醉特点。方法 回顾分析2015年1月～2016年1月在我院进行急诊手术的58例合并2型糖尿病患者临床资料，依据患者病情选择合理的全麻或者硬膜外麻醉，并给予针对性的麻醉管理。结果 全麻患者术后1 h血糖、胰岛素、尿酮明显高于硬膜外麻醉，差异有统计学意义（P0.05）；全麻患者术后24 h血糖、尿酮高于硬膜外麻醉，差异有统计学意义（P0.05）；全麻患者术后并发症发生率高于硬膜外麻醉，差异有统计学意义（P0.05）。结论 老年2型糖尿病患者急诊手术麻醉中采用硬膜外麻醉对于血糖水平的影响小于全麻，并且给予针对性的麻醉管理，可以有效减少麻醉意外和并发症的发生率。 　　关键词：2型糖尿病；急诊手术；麻醉管理 　　Abstract：Objective To study the anesthesia management of emergency operation in elderly patients with type 2 diabetes mellitus， and to summarize the characteristics of anesthesia in emergency patients with diabetes mellitus. Methods A retrospective analysis of January 2015 to 2016 during January in our hospital for emergency surgery in 58 cases were combined with clinical data on patients with type 2 diabetes， according to the patients condition choice reasonable general anesthesia or epidural anesthesia， and to provide the basis for the anesthetic management. Results After general anesthesia 1 h blood glucose， insulin， urine ketone was significantly higher than that of epidural anesthesia， the difference is statistically significant （P 0.05）； general anesthesia after 24 h blood glucose and urine ketone higher than epidural anesthesia， the difference is statistically significant （P 0.05）； general anesthesia patients with postoperative complication rate is higher in the epidural anesthesia， the difference is statistically significant （P 0.05）. Conclusion Emergency surgery in elderly patients with type 2 diabetes mellitus anesthesia with epidural anesthesia effect on blood glucose levels of less than general anesthesia， and given for the anesthetic management， can effectively reduce the incidence of anesthesia accident and complication of the. 　　Key words：Type 2 diabetes mellitus；Emergency operation； Anesthesia management 　　糖尿病是由于胰岛素绝对或者相对不足以及不同程度的胰岛素对抗，引起的碳水化合物、脂肪。蛋白质代谢异常紊乱的综合症。糖尿病会胰岛多器官系统疾病，会造成全身小血管和神经损伤，尤其是老年2型糖尿病患者，在急诊手术麻醉过程中可能会使糖尿病加重，引起相关并发症的发生[1]。所以，在急诊手术时临床麻醉师应该依据老年2型糖尿病患者生理特点和病情，选择合理的麻醉方式，并且给予相