Relationship between perioperative glycemic control and postoperative infections
Relationship between perioperative glycemic control and postoperative infections
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DOI：
10.3748/wjg.15.4122
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发表时间：
2009-09-07
影响因子：
4.3
通讯作者：
Okabayashi, Takehiro
中科院分区：
文献类型：
--
作者：
Hanazaki, Kazuhiro;Maeda, Hiromichi;Okabayashi, Takehiro
危重手术患者的围手术期高血糖增加了术后感染（POI）的风险，这是一种常见且通常昂贵的手术并发症。高血压与白细胞功能异常有关，包括粒细胞粘附、吞噬功能受损、趋化性延迟和杀菌能力降低。这些白细胞缺乏是感染的原因，并通过严格的血糖控制得到改善，这导致危重手术患者的POI减少。严格的血糖控制，如强化胰岛素治疗，有低血糖的风险。此外，降低POI的最佳目标血糖范围仍然未知。自2006年以来，我们研究了使用闭环人工内分泌胰腺系统进行严格的围手术期血糖控制，以减少POI并避免低血糖。在本主题要点中，我们回顾了围手术期血糖控制和POI之间的关系，包括人工胰腺的使用。(C)2009年，WIG出版社和百世登。版权所有
Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis, and depressed bactericidal capacity. These leukocyte deficiencies are the cause of infection and improve with tight glycemic control, which leads to fewer POIs in critically ill surgical patients. Tight glycemic control, such as intensive insulin therapy, has a risk of hypoglycemia. In addition, the optimal targeted blood glucose range to reduce POI remains unknown. Since 2006, we have investigated tight perioperative blood glucose control using a closed-loop artificial endocrine pancreas system, to reduce POI and to avoid hypoglycemia. In this Topic Highlight, we review the relationship between perioperative glycemic control and POI, including the use of the artificial pancreas. (C) 2009 The WIG Press and Baishideng. All rights reserved