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目的探讨腰椎结核合并糖尿病患者围术期的血糖控制及其对手术效果的影响。方法回顾性分析2005年11月至2013年12月我科手术治疗的38例腰椎结核合并糖尿病患者围术期血糖控制情况,术后切口愈合、植骨融合及结核复发情况。结果 38例患者,男14例,女24例;年龄22~82岁,平均(58.6±13.2)岁。血糖控制情况:术前空腹血糖(7.5±1.7)mmol/L,餐后血糖(9.3±1.4)mmol/L;术后空腹血糖(8.3±1.7)mmol/L,餐后血糖(9.4±1.5)mmol/L;术中血糖(9.6±1.3)mmol/L;围术期空腹血糖范围5.8~10.0 mmol/L,餐后血糖范围7.9~10.9 mmol/L。36例患者切口甲级愈合,愈合时间7~10 d,平均(8.2±0.8)d,2例患者切口延迟愈合,38例患者均未发生切口感染;35例患者植骨融合,融合时间3~5个月,平均(3.9±0.8)个月,2例患者植骨吸收;术后随访12~18个月,平均(15.0±1.8)个月,37例患者均未发生结核复发现象,1例失访。结论腰椎结核合并糖尿病患者围术期空腹血糖控制在5.8~10.0 mmol/L,餐后血糖控制在7.9~10.9 mmol/L,术中血糖控制在(9.6±1.3)mmol/L,行骨科手术是安全的。
Objective To investigate the perioperative blood sugar control in patients with lumbar tuberculosis complicated with diabetes mellitus and its effect on the surgical outcome. Methods A retrospective analysis of perioperative blood glucose control, postoperative incision healing, bone fusion and tuberculosis recurrence in 38 patients with lumbar tuberculosis complicated with diabetes mellitus treated in our department from November 2005 to December 2013 was retrospectively analyzed. Results 38 patients, 14 males and 24 females; aged 22 to 82 years, mean (58.6 ± 13.2) years. Blood glucose control: Preoperative fasting blood glucose (7.5 ± 1.7) mmol / L and postprandial blood glucose (9.3 ± 1.4) mmol / L; fasting blood glucose (8.3 ± 1.7) mmol / L and postprandial blood glucose (9.4 ± 1.5) (9.6 ± 1.3) mmol / L. The perioperative fasting plasma glucose ranged from 5.8 to 10.0 mmol / L and the postprandial blood glucose ranged from 7.9 to 10.9 mmol / L. Thirty-six patients had grade A healed wounds, the healing time was 7 to 10 days, with an average of (8.2 ± 0.8) days. The incision delayed healing in 2 patients and none of the 38 patients had any incisional wound infection. In 35 patients, bone fusion and fusion time were 3 ~ 5 months, mean (3.9 ± 0.8) months, and 2 patients were absorbed by the bone graft. The patients were followed up for 12-18 months (mean, 15.0 ± 1.8) months. None of the 37 patients had tuberculosis recurrence, Lost CONCLUSION: The fasting blood glucose control during perioperative period in patients with lumbar tuberculosis complicated with diabetes is 5.8-10.0 mmol / L, the postprandial blood glucose level is 7.9-10.9 mmol / L, and the intraoperative blood glucose control is (9.6 ± 1.3) mmol / L. The orthopedic surgery is safe.