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术前糖化血红蛋白(HbA1c)水平是合理判断患者近几个月血糖控制情况的重要指标,并被用于估计术前和术中胰岛素的需要量。严格的血糖控制应能减少手术并发症和改善预后。本研究回顾148例合并重度肢体缺血的糖尿病患者接受介入治疗的情况,分析HbA1c是否与合并重度肢体缺血的糖尿病患者病情的严重程度相关。结果提示,对合并重度肢体缺血的糖尿病患者,通过HbA1c判断血糖控制不能评价疾病的严重程度和是否需要再次介入治疗,糖尿病相关的其他因素影响外周血管疾病的发生,需要大型的前瞻性的临床试验来评估血糖控制在重度肢体缺血中的应用。后续研究还将关注何种麻醉方式适合合并肢体缺血的糖尿病患者。
The preoperative HbA1c level is an important indicator of a reasonable judgment of the patient’s glycemic control in recent months and is used to estimate the need for preoperative and intraoperative insulin. Strict glycemic control should reduce surgical complications and improve prognosis. This study reviewed the interventional treatment of 148 patients with diabetes mellitus complicated with severe limb ischemia and analyzed whether HbA1c is associated with the severity of the condition in diabetic patients with severe limb ischemia. The results suggest that judging by HbA1c, blood glucose control can not evaluate the severity of the disease and need to be intervened again in diabetic patients with severe limb ischemia. Other factors related to diabetes affect the occurrence of peripheral vascular diseases and require large-scale prospective clinical Test to assess the use of glycemic control in severe limb ischemia. Follow-up research will also focus on what type of anesthesia is suitable for patients with diabetes mellitus and limb ischemia.