Effects Of Intensive Insulin Therapy On The Prognosis Of Mitral Valve Replacement In Perioperative Period

To study the perioperative hyperglycemia occurring mechanism and control measures of the CPB heart surgery in patients and to provide experimental basis and theoretical for the heart CPB surgery in patients with postoperative recovery and in intraoperative and postoperative blood glucose levels monitoring.Methods:From January2010to March2013,the70patients in Changzhi medical college affiliated hospital in peace were investigate and study through the control of the blood sugar.They all received Mitral valve replacement in the heart CPB,and were randomly divided into two groups. The two groups were implantated insulin pumpin intraoperative.A set of them are according to the conventional methods for treatment (controlling blood sugar levels between8.4～11.1mmol/1), another group are in accordance with the method of improved insulin infusion treatment (controlling blood sugar levels between4.4～8.3mmol/1)。 Contrast and analysis two groups and record the blood glucose of patients with an empty belly,preoperative,after CPB blocking, admission, preoperative fasting glucose, CBP after blocking, and immediate postoperative blood glucose after downtime, surgery after8h,1h every one test should be carried out on blood sugar; Every2h between8～24h blood glucose testing again; Every3h between24～48h to a blood glucose testing. Postoperative respirator assisted ventilation time record each patient at the same time, in the heart, ICU stay time, postoperative hospitalization days, perioperative cardiac events, infection of incisional wound and hypoglycemic events.Results:Intensive insulin trerapy group pacients in the postoperative respirator assisted ventilation time, staying time into the heart ICU are reduced, and infection of incisional wound were decreased, with statistical significance (P<0.05). Although strengthening groups reduce hospitalization time after the surgery, cardiac events were reduced,but no statistical difference. And compared with the conventional treatment group hypoglycemia events is more, there was no significant difference statistically.Conclusions:In the extracorporeal circulation of mitral valve replacement, perioperative hyperglycemia control by intensive insulin treatment can reduce the postoperative complications.It is beneficial to patients with postoperative recovery.