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心脏手术患者围手术期的血糖控制

Perioperative glycemic control in patients undergoing cardiac surgery.

作者信息

Bednarski Dariusz, Krzych Łukasz J

机构信息

Department of Anesthesiology and Intensive Care, School of Medicine, Medical University of Silesia, Katowice, Poland.

Department of Cardiac Anesthesiology and Intensive Care, Silesian Center for Heart Diseases, Zabrze, Poland.

出版信息

Kardiochir Torakochirurgia Pol. 2025 Mar;22(1):44-52. doi: 10.5114/kitp.2025.148548. Epub 2025 Mar 17.

Abstract

Diabetes mellitus (DM) is one of the most common chronic diseases, affecting globally about 537 million adults. Cardiovascular disease remains the leading cause of death and medical emergencies in the DM patient population. As a result, about 40% of patients with DM undergo cardiac surgery, mainly in the coronary arteries. Uncontrolled hyperglycemia, especially the prolonged condition, is an independent factor in postoperative mortality and the cause of many serious complications, such as surgical wound infection, sepsis, renal failure or cerebral or cardiovascular incidents. Adequate glycemic control in the perioperative period is the most important way to prevent the above complications. The issue has remained an important topic of many observational and experimental studies for years. This paper summarizes the current knowledge with regard to strategies of hyperglycemic control in patients undergoing cardiac surgery.

摘要

糖尿病(DM)是最常见的慢性病之一,全球约有5.37亿成年人受其影响。心血管疾病仍然是糖尿病患者群体中死亡和医疗紧急情况的主要原因。因此,约40%的糖尿病患者接受心脏手术,主要是冠状动脉手术。血糖控制不佳,尤其是长期血糖控制不佳,是术后死亡率的独立因素,也是许多严重并发症的原因,如手术伤口感染、败血症、肾衰竭或脑或心血管事件。围手术期充分的血糖控制是预防上述并发症的最重要方法。多年来,这个问题一直是许多观察性和实验性研究的重要课题。本文总结了目前关于心脏手术患者高血糖控制策略的知识。

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