药物镇痛方法对糖尿病颅脑手术患者术后血糖水平的影响(1)
[摘要] 目的 對比糖尿病颅脑手术患者运用芬太尼复合氟哌啶静脉泵输注、口服盐酸曲马多缓释片对血糖的影响效果。 方法 选择2017年11月—2019年7月于该院收治的54例糖尿病颅脑手术患者为该次研究的对象，降低均分成两组，分别为对照组与实验组，每组27例。实验组进行芬太尼复合氟哌啶静脉泵输注，对照组口服盐酸曲马多缓释片，术后1 h、3 h、6 h、12 h、24 h微血管采血测定血糖，对比实验组与对照组的血糖变化情况与术后不同时间的VAS评分。结果 实验组术前、术后1 h、术后3 h、术后6 h、术后12 h、术后24 h的血糖水平是(7.25±0.36)mmol/L、(7.34±0.68)mmol/L、(7.39±0.51)mmol/L、(7.37±0.48)mmol/L、(7.36±0.45)mmol/L、(7.36±0.42)mmol/L，对照组分别为(7.24±0.38)mmol/L、(7.40±0.82)mmol/L、(8.93±0.92)mmol/L、(8.48±0.55)mmol/L、(8.31±0.46)mmol/L、(7.95±0.50)mmol/L。经治疗后，实验组患者术后1 h、3 h、6 h、12 h的血糖与术前差异无统计学意义(P>0.05)，排除术后1 h，对照组每个时点的血糖数值高于术前，差异有统计学意义(P<0.05)，除术后1 h外，相较于对照组来说，实验组患者各个时间段的血糖更低，差异有统计学意义(P<0.05)。实验组术后不同时点的VAS评分明显低于对照组，差异有统计学意义(P<0.05)。结论 芬太尼复合氟哌啶静脉泵输注能够降低患者出现抑制反应，患者血糖水平处于稳定的状况中，康复时间提前，从而此种方法应在临床中被广泛推广。
[关键词] 药物镇痛;糖尿病颅脑手术;血糖水平
[中图分类号] R4 [文献标识码] A [文章编号] 1672-4062(2020)03(b)-0003-03
[Abstract] Objective To compare the effect of fentanyl combined with droperidol intravenous pump and oral tramadol hydrochloride sustained-release tablets on blood glucose in patients with diabetic craniocerebral surgery. Methods 54 patients with diabetic craniocerebral surgery who were treated in the hospital from November 2017 to July 2019 were selected as the subjects of this study. The patients were divided into two groups， the control group and the experimental group， with 27 cases in each group. The experimental group received fentanyl and droperidol intravenous pump infusion. The control group received oral tramadol hydrochloride sustained-release tablets. Blood glucose changes and VAS scores at different times after surgery were measured at 1 h， 3 h， 6 h， 12 h， and 24 h after the operation. Results The blood glucose levels of the experimental group before surgery， 1 hour after surgery， 3 hours after surgery， 6 hours after surgery， 12 hours after surgery， and 24 hours after surgery were (7.25±0.36) mmol/L， (7.34±0.68) mmol/L， (7.39±0.51) mmol/L， (7.37±0.48) mmol/L， (7.36±0.45) mmol/L， (7.36±0.42) mmol/L， the control group was (7.24±0.38) mmol/L， (7.40±0.82) mmol/L， (8.93±0.92) mmol/L， (8.48±0.55) mmol/L， (8.31±0.46) mmol/L， (7.95±0.50) mmol/L. After treatment， there was no statistically significant difference in blood glucose at 1 h， 3 h， 6 h， and 12 h after the operation in the experimental group (P>0.05). Excluding 1h after the operation， the blood glucose value at each time point in the control group was higher than that before， the difference was statistically significant (P<0.05). Except for 1 hour after surgery， compared with the control group， the blood glucose of patients in the experimental group was lower in each time period， and the difference was statistically significant (P<0.05). The VAS scores at different time points in the experimental group were significantly lower than those in the control group， and the difference was statistically significant (P<0.05). Conclusion Infusion of fentanyl combined with droperidol can reduce the inhibitory response of patients， the blood glucose level of patients is stable， and the recovery time is advanced. Therefore， this method should be widely promoted in clinical practice.(张国华)