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目的研究麻醉管理在老年糖尿病患者手术中的效果。方法选择2009年3月—2011年5月期间住院治疗的37例老年糖尿病患者为观察对象,从术前、术中、术后三个环节入手,开展科学合理的血糖、尿酮监测和控制,严密观察呼吸、血压及水电解质平衡等情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 37例患者手术中血糖均值为(9.1±2.2)mmol/L,血糖保持平稳;术后24 h血糖均值为(11.3±3.7)mmol/L,尿酮(+/-)为2/35与术前血糖均值(7.7±1.9)mmol/L,尿酮(+/-)0/37比较,血糖均值略有提高,个别患者尿酮阳转,但均保持在一个较为理想的范围。所有患者均无糖尿病酮症酸中毒、高渗性非酮症性高血糖昏迷及低血糖症发生。结论在老年糖尿病患者手术中采取全身麻醉,要采取积极的预防措施,有效预防血糖波动所带来的手术风险,提高其手术安全性。
Objective To study the effect of anesthesia management in elderly diabetic patients. Methods Thirty-seven elderly diabetic patients hospitalized during the period from March 2009 to May 2011 were selected as the observational subjects. From the three aspects of preoperative, intraoperative and postoperative follow-up, scientific and reasonable blood glucose and urine ketone monitoring and control were carried out. Observe the respiration, blood pressure and water and electrolyte balance and so on. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The average blood glucose level was (9.1 ± 2.2) mmol / L during the operation in 37 patients, and the blood glucose remained stable. The average blood glucose level was (11.3 ± 3.7) mmol / L at 24 hours after operation and 2/35 Before the average blood glucose (7.7 ± 1.9) mmol / L, urine ketone (+/-) 0/37 compared to a slight increase in mean blood glucose, individual patients with positive urinary ketone, but were maintained in a more desirable range. All patients had no diabetic ketoacidosis, hypertonic non-ketotic hyperglycemic coma and hypoglycemia. Conclusion Taking general anesthesia in the elderly patients with diabetes mellitus, we should take positive precautionary measures to effectively prevent the surgical risks brought by blood glucose fluctuations and improve the safety of surgery.