本文選題：麻醉 + 增殖性糖尿病視網(wǎng)膜病變��； 參考：《中國(guó)老年學(xué)雜志》2017年19期

【摘要】：目的探討右美托咪定對(duì)老年增生性糖尿病性視網(wǎng)膜病變(PDR)玻璃體切除術(shù)患者血糖影響及與白細(xì)胞介素(IL)-18、骨橋蛋白(OPN)的相關(guān)性。方法行玻璃體切除的PDR患者按照手術(shù)麻醉方式分為觀察組36例與對(duì)照組39例。對(duì)照組采用局部麻醉,觀察組在對(duì)照組基礎(chǔ)上術(shù)前輔助右美托咪定。結(jié)果兩組術(shù)前、手術(shù)結(jié)束時(shí)及術(shù)后3 d糖化血紅蛋白(HbA1c)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組術(shù)后1 d HbA1c水平明顯低于對(duì)照組(P0.05)。觀察組術(shù)后1 d HbA1c水平高于術(shù)前,對(duì)照組術(shù)后1 d HbA1c水平分別高于術(shù)前及手術(shù)結(jié)束時(shí),術(shù)后3 d HbA1c水平下降并恢復(fù)正常(P0.05);觀察組術(shù)后1 d房水中IL-18明顯低于對(duì)照組,觀察組患者術(shù)后1 d房水中OPN則高于對(duì)照組,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組術(shù)后1 d房水中IL-18與HbA1c呈正相關(guān)(r=0.368,P=0.027),觀察組術(shù)后1 d房水OPN與HbA1c呈負(fù)相關(guān)(r=-0.331,P=0.049)。結(jié)論右美托咪定對(duì)PDR玻璃體切除術(shù)局麻前后血糖影響較小,麻醉效果較好,房水IL-18、OPN改變與血糖波動(dòng)存在一定的線性關(guān)系。
[Abstract]:Objective to investigate the effect of dexmetomidine on blood glucose in elderly patients with proliferative diabetic retinopathy (PDR) after vitrectomy and its correlation with interleukin (IL) IL-18 and osteopontin (OPN). Methods PDR patients undergoing vitrectomy were divided into observation group (n = 36) and control group (n = 39). The control group was treated with local anesthesia, and the observation group was treated with dexmetomidine before operation on the basis of the control group. Results there was no significant difference in HbA1c between the two groups before operation, at the end of operation and 3 days after operation. The level of HbA1c in the observation group was significantly lower than that in the control group on 1 day after operation (P 0.05). The level of HbA1c in the observation group was higher than that before operation 1 day after operation, the HbA1c level in the control group was higher than that before operation and at the end of the operation, the HbA1c level decreased and returned to normal on the 3rd day after operation, and the IL-18 in aqueous humor of the observation group was significantly lower than that of the control group on the first day after operation. The OPN in aqueous humor water in the observation group was higher than that in the control group on the 1st day after operation, the difference was statistically significant (P 0.05), the IL-18 and HbA1c in the aqueous humor water in the observation group were positively correlated with HbA1c on the 1st day after operation, and there was a negative correlation between OPN and HbA1c in the observation group on the 1st day after operation. Conclusion dexmetomidine has little effect on blood glucose before and after PDR vitrectomy, and the effect of anesthesia is better. There is a linear relationship between changes of IL-18 OPN in aqueous humor and blood glucose fluctuation.
【作者單位】： 濟(jì)南市第三人民醫(yī)院麻醉科;濟(jì)南市中心醫(yī)院眼科;
【分類號(hào)】：R614

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