对比分析两种麻醉方法对糖尿病腹部手术患者的作用.docx

对比分析两种麻醉方法对糖尿病腹部手术患者的作用 湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院湖南长沙410013 【摘 要】目的探讨全身麻醉(GA)和全身麻醉复合硬膜外阻滞麻醉 (CGEA)对糖尿病(DM)患者腹部手术中血糖值的影响，对比两种麻醉方法的 作用效果，为临床研究提供证据。方法选取2012年9月一 2014年9月间在该 院接受腹部手术的糖尿病患者104例，将其随机分为观察组与对照组，每组各 52例患者，观察组患者采用全麻复合硬膜外麻醉，对照组患者采用全麻。记录 并比较两组患者在术前30min、手术开始、手术开始后30min.手术开始后60rain, 血糖(PG)值。结果 观察组患者在手术前30min.手术开始、手术开始后30min、 手术开始后60min, PG值均波动值小于对照组患者，数据差异有统计学意义 (Pt;0. 05)o结论 使用全麻复合硬膜外麻醉，患者在术中PG值波动都较小， PG值变化较小，所以全麻复合硬膜外麻醉可作为糖尿病患者进行腹部手术时的 首选麻醉方法。 【关键词】糖尿病；腹部手术；全麻；全麻复合硬膜外麻醉；PG值 Abstract： Objective To investigate the effect of general anesthesia (GA) and general anesthesia combined with epidural block anesthesia (CGEA) on blood glucose in patients with diabetes mellitus (DM), and to provide evidenee for clinical research by comparing the effect of two anesthesia methods. Methods 104 diabetic patients with abdominal surgery in the hospital from September 2014 to September 2012 were randomly divided into observation group and control group, 52 cases in each group, the observation group were treated with general anesthesia combined with epidural anesthesia, the control group was treated with general anesthesia. Record and compare the two groups of patients in the preoperative 30min, operation, after the start of the operation, 30min, after the start of the operation, 60rain, blood glucose (PG) value. Results the patients in the observation group were sign讦icantly less than those in control group (Plt;0.05) after 30min, operation, 30min, 60min, PG, and values were less than those in the control group. Conclusion the use of general anesthesia combined with epidural anesthesia, patients in the PG value fluctuations are smalb the PG value is smaller, so the general anesthesia combined with epidural anesthesia can be used as the first choice for patients with diabetes mellitus patients undergoing abdominal surgery. Keywords diabetes mellitus； abdominal surgery； general anesthesia； epidural anesthesia combined with general anesthesia； PG value 在进行外科手术的患者中，有2%的患者合并有糖尿病。糖尿病患者自 身