非糖尿病头颈部肿瘤患者术后应激性高血糖发生情况及影响因素分析(1)
[摘要] 目的 調查非糖尿病头颈部肿瘤术后行肠内营养支持患者发生应激性高血糖的情况并分析其影响因素，为术后的血糖管理提供参考。 方法 回顾性分析我院2017年5月～2018年11月收治的非糖尿病头颈部肿瘤术后行肠内营养支持患者97例的临床资料，统计应激性高血糖的发生率，并对性别、年龄、手术持续时间、气管切开、术后2次手术、输血、使用激素、BMI、营养风险、术前营养支持、血清白蛋白<30 g/L先后进行单因素分析及多因素Logistic回归分析。 结果 97例患者中术后发生应激性高血糖共76例，发生率为78.4%。术后第1日，97例患者的平均空腹血糖值达到最高点为(8.27±2.52)mmol/L;在出院时，患者的平均空腹血糖值已降至正常范围(6.04±0.89)mmol/L，但仍未恢复至术前水平。单因素分析结果显示年龄、术前营养支持为患者术后发生应激性高血糖的影响因素(P<0.05)。经多因素Logistic回归分析结果显示，手术持续时间、体质量指数为患者术后发生应激性高血糖的独立影响因素(P<0.05)。 结论 非糖尿病头颈部肿瘤术后行肠内营养支持患者应激性高血糖的发生率较高，应重视其术后血糖的管理。
[关键词] 非糖尿病;头颈部肿瘤;肠内营养;应激性高血糖;影响因素
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-9701(2019)25-0023-05
Analysis of postoperative stress hyperglycemia and its influencing factors in patients with non-diabetic head and neck cancer
CHEN Jiaojiao TU Yi LIANG Guanmian
Department of Head and Neck Surgery， Zhejiang Cancer Hospital， Hangzhou 310022， China
[Abstract] Objective To investigate the prevalence of stress hyperglycemia in patients with enteral nutrition after non-diabetic head and neck tumors and to analyze the influencing factors， so as to provide reference for postoperative blood glucose management. Methods The clinical data of 97 patients with enteral nutrition support after non-diabetic head and neck cancer admitted from May 2017 to November 2018 in our hospital were retrospectively analyzed. The incidence of stress hyperglycemia was statistically analyzed. Univariate analysis and multivariate logistic regression analysis of gender， age， duration of surgery， tracheotomy， second operation after surgery， blood transfusion， hormone use， BMI， nutritional risk， preoperative nutritional support， and serum albumin <30 g/L were performed. Results A total of 76 patients with stress hyperglycemia occurred in 97 patients， and the incidence rate was 78.4%. On the first postoperative day， the average fasting blood glucose level of 97 patients reached the highest point(8.27±2.52) mmol/L; at discharge， the average fasting blood glucose level of the patient had dropped to the normal range (6.04±0.89) mmol/L， but still not restored to the preoperative level. Univariate analysis showed that age and preoperative nutritional support were the influencing factors of postoperative stress hyperglycemia(P<0.05). Multivariate logistic regression analysis showed that the duration of surgery and body mass index were independent influencing factors of postoperative stress hyperglycemia(P<0.05). Conclusion The incidence of stress hyperglycemia in patients with enteral nutrition support after non-diabetic head and neck tumors is high， and the management of postoperative blood glucose should be paid attention to., 百拇医药(陈姣姣 屠奕 梁冠冕)
[关键词] 非糖尿病;头颈部肿瘤;肠内营养;应激性高血糖;影响因素
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-9701(2019)25-0023-05
Analysis of postoperative stress hyperglycemia and its influencing factors in patients with non-diabetic head and neck cancer
CHEN Jiaojiao TU Yi LIANG Guanmian
Department of Head and Neck Surgery， Zhejiang Cancer Hospital， Hangzhou 310022， China
[Abstract] Objective To investigate the prevalence of stress hyperglycemia in patients with enteral nutrition after non-diabetic head and neck tumors and to analyze the influencing factors， so as to provide reference for postoperative blood glucose management. Methods The clinical data of 97 patients with enteral nutrition support after non-diabetic head and neck cancer admitted from May 2017 to November 2018 in our hospital were retrospectively analyzed. The incidence of stress hyperglycemia was statistically analyzed. Univariate analysis and multivariate logistic regression analysis of gender， age， duration of surgery， tracheotomy， second operation after surgery， blood transfusion， hormone use， BMI， nutritional risk， preoperative nutritional support， and serum albumin <30 g/L were performed. Results A total of 76 patients with stress hyperglycemia occurred in 97 patients， and the incidence rate was 78.4%. On the first postoperative day， the average fasting blood glucose level of 97 patients reached the highest point(8.27±2.52) mmol/L; at discharge， the average fasting blood glucose level of the patient had dropped to the normal range (6.04±0.89) mmol/L， but still not restored to the preoperative level. Univariate analysis showed that age and preoperative nutritional support were the influencing factors of postoperative stress hyperglycemia(P<0.05). Multivariate logistic regression analysis showed that the duration of surgery and body mass index were independent influencing factors of postoperative stress hyperglycemia(P<0.05). Conclusion The incidence of stress hyperglycemia in patients with enteral nutrition support after non-diabetic head and neck tumors is high， and the management of postoperative blood glucose should be paid attention to., 百拇医药(陈姣姣 屠奕 梁冠冕)