您知道脊髓感觉阻滞持续时间在糖尿病重要内分泌紊乱中的作用吗?前瞻性观察研究

Tuna Albayrak, Mücahit Coşkun, I. Sengul, Aysegul Torun Goktas, D. Sengul, Mehmet Albayrak, T. Kesicioglu, Esma Cinar
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摘要

摘要 目的:糖尿病本身是一个全球关注的健康问题,通常伴有糖尿病神经病变等并发症。本前瞻性观察研究旨在评估接受脊髓麻醉的糖尿病患者和非糖尿病患者的脊髓感觉阻滞和运动阻滞的持续时间。方法:本研究纳入了 80 个病例,平均分为无糖尿病的脊髓感觉阻滞和有糖尿病的脊髓感觉阻滞。在不同时间点记录了各种参数,包括心率、平均动脉血压、SpO2 和脊髓阻滞特征。值得注意的指标包括最大脊髓感觉阻滞开始时间、到达第 10 胸椎(T10)的时间、最大脊髓感觉阻滞、Bromage 评分时间和阻滞回归,同时控制与年龄有关的变化。结果:糖尿病组患者的阻滞时间延长,在特定时间点的心率有显著差异。在脊髓阻滞特征方面,SSBwDM 患者的 "SSB 最大起始时间 "和 "到达 T10 的时间 "更长,但无显著性差异。最大感觉脊髓阻滞没有差异。然而,SSBwDM 中的一些病例显示出延伸至 T6 的阻滞。在 SSBwDM 中,达到 Bromage 运动阻滞 1-3 分的时间较短,但与年龄无关。值得注意的是,SSBwDM 的回归时间更长,这对两个参数都有显著意义。结论:糖尿病病例在蛛网膜下腔介入治疗后通常会遇到阻滞时间延长的问题,这可能与神经敏感性、年龄相关变化和血糖控制有关。因此,为糖尿病神经病变病例减小局部剂量可提高早期活动能力、减少血栓栓塞事件并加快胃肠道恢复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Do you mind the role of spinal sensory block duration in a crucial endocrine disorder of diabetes mellitus? A prospective observational study
SUMMARY OBJECTIVE: Diabetes mellitus, per se, is a global health concern, which is often accompanied by complications such as diabetic neuropathy. This prospective observational study purposed to assess the durations of spinal sensory block and motor blocks in individuals with and without diabetes mellitus who had undergone spinal anesthesia. METHODS: This study incorporated 80 cases, which were evenly divided into spinal sensory block without diabetes mellitus and spinal sensory block with diabetes mellitus. Various parameters were recorded at different time points, including heart rate, mean arterial blood pressure, SpO2, and spinal block characteristics. Notable measures included maximum spinal sensory block onset time, time to reach the 10th thoracic vertebra (T10), maximal spinal sensory block, time for Bromage scores, and block regression while controlling for age-related variations. RESULTS: Patients in the diabetic group exhibited extended block durations, with significant differences in heart rate noted at specific time points. Regarding the spinal block characteristics, the “maximum onset of SSB” and the “time to reach the T10” were more prolonged in the SSBwDM without significance. Maximum sensory spinal sensory block did not differ. However, some cases in the SSBwDM displayed blocks extending up to the T6. The times to achieve Bromage motor block scores 1–3 were shorter in SSBwDM and lost significance regarding age. Notably, the regression time was longer in SSBwDM, which held significance for both parameters. CONCLUSION: Diabetic cases commonly encounter prolonged block durations post-subarachnoid intervention, potentially linked to nerve sensitivity, age-related changes, and glycemic control. As such, attenuated local doses for diabetic neuropathic cases may enhance early mobilization, attenuate thromboembolic events, and expedite gastrointestinal recovery.
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