糖尿病,手术前的血糖控制和术后的结果:一个多民族的亚洲观点
Roderica Rui Ge Ng1,2,3, Charlene Xian Wen Kwa1, Yuhe Ke1
1Department of Anaesthesiology & Perioperative Medicine, Singapore General Hospital, Singapore, Singapore.
Clinical medicine insights. Endocrinology and diabetes
|July 28, 2025
概括
糖尿病 (DM) 增加了术后并发症. 手术前的糖化血红蛋白 (HbA1c) 显示出与并发症的U形关联,表明低水平和高水平的风险.
科学领域:
- 在外科手术期间的医学.
- 内分泌学 在内分泌学.
- 手术结果研究研究.
背景情况:
- 糖尿病 (DM) 是术后并发症的重要危险因素.
- 术前血糖控制,通过糖化血红蛋白 (HbA1c) 测量,对于患者风险分层至关重要.
- 在不同亚洲人群中,DM,HbA1c和外科手术后期结果之间的关系尚不清楚.
研究的目的:
- 调查先前存在的DM和低于最佳的血糖控制 (HbA1c ≥7%) 与术后并发症之间的关联.
- 评估HbA1c作为选择性非心脏手术患者的风险分层工具.
- 探索DM和HbA1c水平对亚洲多民族队列中术后结果的影响.
主要方法:
- 来自第三级医院的688名患者的潜在队列的二次分析.
- 使用综合性并发症指数评估术后并发症.
- 多变量后勤回归分析以确定DM,HbA1c水平和并发症之间的关联.
主要成果:
- 糖尿病与术后并发症风险增加2.57倍独立相关 (aOR 2.57,P = .015).
- 在DM患者和低于最佳的血糖控制 (aOR 1.39,P = .482) 中,出现并发症增加的趋势,但这在统计学上并不显著.
- 在手术前HbA1c水平和术后并发症之间观察到U形关系,低HbA1c值和高HbA1c值的风险更高.
结论:
- 糖尿病与术后并发症的增加有显著联系.
- HbA1c和并发症之间的U形关系凸显了在整个血糖谱中进行风险评估的必要性.
- 在亚洲人群中,常规的HbA1c查和量身定制的术后策略可以改善外科手术结果,并支持DM管理.
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