糖尿病を合併した口腔外科入院患者の全身麻酔下手術に伴う血糖変化

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We investigated the incidence of the worse change in diabetic control after a surgery under a general anestesia without following intravenous feeding among 49 diabetic patients hospitalized in the First or Second Depatmentof Oral and Maxillofacial Surgery division of Kyushu Dental Collage Hospital. The worse change in diabetic control was diagnosed from an increase in the fasting blood glucose level of more than 30 mg/dl, and/or a need for the more intensive therapy for diabetic control after the surgery. The relationship was evaluated between the worse change in diabetic control and the cause of surgery, preoperative diabetic therapy, age, body-mass index, operation time, total perioperative steroid administration, and hemoglobin Alc (n=33), serum fructosamine, fasting blood glucose, CRP levels measured just before surgery. The worse change in diabetic control was observed in 53%, and continued more than 3 days after surgery in 33% of the patients. The patients with inflammatory disease or malignant tumor showed higher incidence of the worse change than the others (78%, 69%, and 30%, respectively, p=0.0011). Although there was no correlation between the worse change in diabetic control and preoperative diabetic therapy, and age, significant correlation was observed in body-mass index (p=0.0036), operation time (p=0.0088), total perioperative steroid administration (p=0.0213), hemoglobin Alc (p=0.0282), serum fructosamine (p=0.0005), fasting blood glucose (p=0.0120), and CRP (p=0.0015) levels. In the patients with slender build, long operation time, perioperative steroid administraion, poor preoperative diabetic control (high levels of hemoglobin Alc, serum fructosamine, and fasting blood glucose), and with inflammation (positive CRP level), high incidence of the worse change in diabetic control after surgery is expected, and blood glucose level should be checked repeatedly in order to achieve good diabetic control after surgery. On the other hand, good preoperative diabetic control also is desirable so as not to worsen the postoperative diabetic control.
九州歯科学会の論文
1998-04-25

糖尿病を合併した口腔外科入院患者の全身麻酔下手術に伴う血糖変化

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