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目的 评价糖尿病患者玻璃体切割手术后血糖变化 ,并分析有关影响因素。 方法 选择接受玻璃体切割手术的II型糖尿病患者 19例 ,测定术前、术后 1～ 2h、1、3、5d空腹血糖。用方差分析、t检验和相关回归分析方法分析术后血糖变化及其与术前基础血糖水平、糖尿病病程、手术时间及术中强化麻醉的相关性。 结果 糖尿病患者玻璃体切割手术后血糖显著高于术前 ,术后 1～ 2h达高峰 ,后逐渐下降(P <0 .0 5 ) ,至 5d基本接近术前水平 (P >0 .0 5 )。血糖升高与手术时间、术前基础血糖水平及糖尿病病程呈正相关 (P <0 .0 5 ) ,与术中强化麻醉有关。 结论 糖尿病患者玻璃体切割手术后血糖变化存在着先升高 ,至 5d左右趋于术前水平的规律。术后血糖变化主要影响因素为术前基础血糖水平、糖尿病病程、手术时间及术中强化麻醉。
Objective To evaluate the changes of blood glucose after vitrectomy in diabetic patients and to analyze the influencing factors. Methods Nineteen patients with type II diabetes mellitus undergoing vitrectomy were enrolled in this study. Fasting blood glucose was measured before and 1, 2, 3, and 5 days after operation. ANOVA, t-test and correlation analysis were used to analyze the postoperative blood glucose changes and its correlation with preoperative baseline blood glucose level, duration of diabetes, operative time and intensive anesthesia. Results The blood glucose of patients with diabetic mellitus after vitrectomy was significantly higher than that before operation. The blood glucose reached the peak at 1 ~ 2 h after operation and then decreased gradually (P <0.05). The level of blood glucose was close to preoperative level at 5 days (P> 0.05). There was a positive correlation between the rise of blood sugar and the operation time, the preoperative baseline blood glucose level and the duration of diabetes mellitus (P <0.05), which was related to intensive anesthesia during operation. Conclusion The blood glucose level of diabetic patients after vitrectomy increased first, and then reached the preoperative level about 5 days. The main influencing factors of postoperative blood glucose were basal blood glucose level, duration of diabetes, operation time and intensive anesthesia during operation.