Gandhi Hemang, Sarvaia Alpesh, Malhotra Amber, Acharya Himanshu, Shah Komal, Rajavat Jeevraj
Department of Cardiac Anesthesia, U N Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
Department of Cardio Vascular and Thoracic Surgery, U N Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
Ann Card Anaesth. 2018 Apr-Jun;21(2):167-172. doi: 10.4103/aca.ACA_128_17.
The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG.
Fifty Patients, who were posted for off-pump CABG with diabetes mellitus type II, were randomized in two group, Group I normal saline + human insulin infusion during the perioperative period, Group II (glargine group): Glargine + human insulin infusion during perioperative period.
During surgery and in the postoperative period, random blood sugar and human insulin requirement are significantly higher in control group than glargine group. Other infection, step-up antibiotics, intensive care unit (ICU) stay, and hospital stay were significantly higher in control groups in postoperative period.
Our study results suggest that glargine effectively manages blood glucose level with significantly greater control over postoperative morbidity.
需要进行冠状动脉旁路移植术（CABG）的患者中糖尿病的患病率显著较高（20%-30%）。这些患者围手术期结局较差，长期生存率降低，且心绞痛复发风险较高。为改善围手术期结局，在此期间手术科室需要达到满意的血糖控制。因此，我们研究的目的是比较甘精胰岛素联合持续静脉输注人胰岛素与单纯持续静脉输注人胰岛素在接受CABG的糖尿病患者围手术期血糖控制中的疗效。
50例计划接受非体外循环CABG的II型糖尿病患者被随机分为两组，I组在围手术期输注生理盐水+人胰岛素，II组（甘精胰岛素组）在围手术期输注甘精胰岛素+人胰岛素。
在手术期间及术后，对照组的随机血糖和人胰岛素需求量显著高于甘精胰岛素组。术后，对照组的其他感染、升级使用抗生素、入住重症监护病房（ICU）时间及住院时间均显著更长。
我们的研究结果表明，甘精胰岛素能有效控制血糖水平，且对术后并发症的控制效果显著更佳。
