Clinical Application Of The Combination Of The DGMS~R Real-Time And CSⅡ In Perioperative Period Of Gastric Bypass Operation

Objective1、 To evaluate the application value of DGMS~R Real-Time in peri-operative ofgastric bypass;2、 To observe the changes of blood glucose, serum insulin and serumC-peptide levels during general anesthesia of Gastric bypass;3、 To discuss clinical application value of the combination of DGMS~R Real-Time and CSⅡ in perioperative period of gastric bypass.Methods1、 We select41patients of type2diabetes mellitus who undergoing GBPduring2011March to2011July in department of General Surgery of theChinese People’s Armed Police General Hospital, using a single blindmethod DGMS~R Real-Time to observe change of blood glucose levelsduring peri-operative period. At the same time using a blood glucose metermonitoring fingertip blood glucose at4time points before surgery、4timepoints in surgery and6time points after surgery. We also respectively drawvenous blood in the preoperative, the beginning of anesthesia, afteranesthesia,60min after anesthesia,120min after anesthesia, anesthesiaawareness five time points, then determine the serum C-peptide, the seruminsulin content in blood. At last we analyze the relevance of finger blood glucose and blood glucose of DGMS~R Real-Time, and observe the changesof blood glucose, serum insulin and serum C-peptide levels during generalanesthesia of Gastric bypass；2、 We select44patients of type2diabetes mellitus who undergoing GBPduring2011March to2011July in department of General Surgery of theChinese People’s Armed Police General Hospital, randomly divided intoexperimental group and control group.20cases of the experimental groupare treated with DGMS~R Real-Time combining with CSⅡ treatment,24casesof the control group are treated with fingertip blood glucose monitoring andinsulin infusion or multiple subcutaneous insulin injection treatment. In thestudy, we will continuously monitor the lever of blood glucose, all-day insulindosage, incidence of hypoglycemia and hyperglycemia throughout thewhole peri-operative.Results1、①DGMS~R Real-Time can find more hypoglycemia and hyperglycemia eventsduring peri-operative period in type2diabetic patients undergoing gastricbypass The blood sugar value of DGMS~R Real-Time is better relevant withthe finger blood glucose;②DGMS~R Real-Time maps show: Since theendotracheal intubation, blood glucose value is gradually increased.Compared with preoperative, anesthetic are decreased, especially in60minafter anesthesia；2、①The experimental group’s lever of blood glucose at different time points ofpreoperative, intraoperative and postoperative are lower than those of thecontrol group. There are significant differences (P<0.05or P<0.01);②Theexperimental group’s lever of average blood glucose in24hours and insulindosage throughout the whole peri-operative period are lower than those ofcontrol group, the differences are statistically significant (P<0.05);③Theexperimental group’s incidence of hypoglycemia and hyperglycemia is lower than those of control group, the differences are statistically significant(P<0.05).Conclusions1、 The blood sugar value of DGMS~R Real-Time is better relevant with the fingerblood glucose. DGMS~R Real-Time can reflect the fluctuating blood glucosedetails much better fluctuating blood glucose details much better；2、 Due to the stress interferes of anaesthesia and surgery in GBP causesblood glucose gradually increased；3、 The therapy being combined DGMS~R Real-Time with CSⅡ treatment isbetter than traditional treatment methods in peri-operative period of gastricbypass.