摘要
目的探讨老年手术患者术中血糖异常的发生现况,并分析其危险因素,为老年手术患者术中血糖的评估及管理提供参考依据。方法采用横断面研究方法,便利抽样选取北京市某三级甲等综合医院2021年6月—12月年龄≥65岁接受手术治疗的208例老年患者为研究对象。术前建立动脉导管进行术中血糖水平测量,电子病例系统收集影响因素相关资料。采用单因素分析和二元Logistic回归分析确定老年患者术中血糖异常的危险因素。结果老年手术患者术中血糖异常发生率为74.5%(155/208),Logistic回归分析结果显示,入室动脉血糖越高(OR=3.530)、手术时长为4.1~5.0h(OR=3.831)和≥5.1h(OR=16.201)、采用全身麻醉方式(OR=4.588)为老年手术患者术中血糖异常的危险因素(均P<0.05)。结论老年手术患者术中血糖异常的发生率较高,入室动脉血糖高、手术时长≥4.1h、全身麻醉方式是老年手术患者术中血糖异常的危险因素,手术室护士应根据其危险因素,早期识别术中血糖异常的发生,尽早采取预防措施,保证手术过程安全,促进患者康复。
Objective To investigate the occurrence of the abnormal blood glucose of aged patients in surgery,analyse the risk factors and provide a reference basis to find out the elderly patients who are in high risk of intraoperative abnormal blood glucose before surgery hence to take prompt and preventive measures.Methods A cross-sectional study was conducted with a continuously sampling method to select 208 elderly patients who were≥65 years old and underwent surgery in a tertiary hospital in Beijing,from June to December 2021 as the research subjects.Preoperative arterial catheterisation was applied to monitor the intraoperative blood glucose.The electronic case system was used to collect relevant data on influencing factors such as general data,laboratory indicators and perioperative indicators.The electronic case system was used to collect relevant data on influencing factors such as general data,laboratory indicators and perioperative indicators.Univariate analysis and binary logistic regression analysis were performed to determine the risk factors of intraoperative abnormal blood glucose of the aged patients.Results The rate of incidence of intraoperative abnormal blood glucose in elderly patients was 74.5%(155/208).Multivariate logistic regression analysis showed that higher ventricular arterial blood glucose on admission(OR=3.530),time of surgery at 4.1-5.0 hours(OR=3.831)and≥5.1 hours(OR=16.201),and general anaesthesia(OR=4.588)were the independent risk factors of the intraoperative blood glucose abnormalities in the aged patients(all P<0.05).Conclusions The incidence of intraoperative abnormal blood glucose in aged patients is relatively high.The risk factors include ventricular arterial blood glucose on admission,time of surgery≥4.1 hours and general anaesthesia.Operating room nurses should identify the occurrence of intraoperative abnormal blood glucose based on the risk factors and take prompt and preventive measures as early as possible in order to ensure the safety of the surgical process and promote patient recovery.
作者
王冉
王林
刘婷
赵磊
Wang Ran;Wang Lin;Liu Ting;Zhao Lei(Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing,100053,China)
出处
《现代临床护理》
2023年第11期11-17,共7页
Modern Clinical Nursing
基金
吴阶平医学基金会临床科研专项资助基金,项目编号320.6750.2020-21-2
首都医科大学宣武医院护理专项青年课题,项目编号HLQN2021010。
关键词
老年患者
手术
血糖异常
横断面研究
the aged
surgery
abnormal blood glucose
cross-sectional study
