Comparative Analysis Of Perioperative Blood Glucose And Blood Lactate Changes In CABG Between Diabetic And Non-diabetic Patients And The Correlation Between Lactic Acid Elevation

OBJECTIVE:Retrospective study of changes in blood glucose and blood lactate before,during and after coronary artery bypass graft(CABG)in diabetic and non-diabetic patients,comparison between the two groups,and study of blood glucose and blood lactate The correlation between the factors affecting the effects of lactic acid changes to guide clinical work.METHODS:A retrospective analysis was performed on 68 patients undergoing elective non-cardiopulmonary bypass CABG during the period from October 2016 to July 2018.68 patients were divided into groups,including 18 patients in the diabetic group and 50 patients in the non-diabetic group.Blood glucose and blood lactate levels were observed before,during and after surgery,respectively.Blood lactate and preoperative,1h,2h and 1 hour after ICU at 1h,2h,4h,6h,12,24 and 48.Blood glucose levels were analyzed for trend,and the differences between the two groups of patients were compared.RESULTS:1 In the diabetic group,the blood glucose level during and after CABG was significantly higher than that in the non-diabetic group(P < 0.05).The blood glucose and blood glucose of the two groups increased with the increase of operation and ICU time.Blood sugar and blood lactic acid gradually increased to the point where they returned to normal again,and peaked at 4 hours after entering the ICU.2 The blood lactate value is almost the same as the blood sugar level.The correlation coefficient between blood glucose and lactic acid was 0.235 by linear correlation analysis,and one side P < 0.01,indicating a positive correlation between the two variables.3 The stratified comparison of the number of vascular lesions,postoperative hospital stay,total length of hospital stay,and postoperative mechanical ventilation time in the diabetic group compared with non-diabetic group3.1 The number of vascular lesions in the diabetic group was significantly higher than that in the non-diabetic group(P=0.03).3.2 The perioperative period of hospitalization and total hospital stay were significantly higher in the perioperative diabetic group than in the non-diabetic group(P<0.01).3.3 The postoperative mechanical ventilation time was significantly higher in the diabetic group than in the non-diabetic group(P<0.05).4 Pearson correlation analysis of perioperative lactate changesPerioperative blood lactate was positively correlated with mean pulmonary artery pressure(MPAP),pulmonary wedge pressure(PAWP),and troponin(CTNT);negatively correlated with cardiac index(CI)and partial pressure of oxygen(PaO2).5 Logistic regression analysis of lactic acid changes and related factors during perioperative periodThe results showed that during perioperative period of CABG,blood glucose and PAWP were independent risk factors for lactic acid elevation.Conclusion:1 Blood glucose and blood lactate after CABG in diabetic patients were significantly higher than those in non-diabetic patients and fluctuated more.Perioperative blood lactate was positively correlated with blood glucose levels.2 Perioperative blood lactate and MPAP,PAWP,CTNT,CI,PaO2 were correlated.3 Multivariate analysis showed that perioperative period,blood glucose and PAWP were independent risk factors for lactic acid elevation.4 The CABG perioperative diabetes group recovered poorer than the non-diabetic group,better controlled blood sugar,maintained blood sugar at a certain level to reduce the damage of high blood sugar to the body,and also effectively reduced blood lactic acid damage to the body.