The Effects On Blood Glucose And Cognitive Function Of Aging Diabetic Patients With Hip Replacement By Stopping Using Metformin In Perioperative Pariod

Purpose:The purpose of this experiment is to explore that stopping use metformininstead of a short-acting insulin to control blood sugar during perioperative period,the effect of postoperative cognitive function and blood glucose fluctuations during unilateral total hip replacement in elderly diabetes patients.Method:We select 79 diabetespatients undergoing elective unilateral total hip replacement,more than 75 years old,ASA ?~ ?level.Divided the patients into three groups.Group A(24 cases):the people who Usually metformin before continue to application during perioperative Group B(28 cases): the people who never use metformin before.Group C(27 cases): the people who use metformin instead of short-acting insulin one day before operation.All of patientsused MMSE and Mo CA scale to evaluate the cognitive function One day before operation.Preoperative cognitive function seriously damage cases were exclude.Useing Cognitive function test again after 5 minutesin drawing tube,1,3,7 days after surgery.Record Renal function before and after operation Record blood glucose before operation,after 5 minutesin drawing tube,1,3,7 days after surgery.Application of VAS pain score to evaluate the degree of postoperative pain in patients.Results:Three groups of patients' basic situation and the comparison of vital signs,the difference was not statistically significant.Comparison of the threegroups of patients' Postoperative nausea and vomiting and The degree of pain,the difference was not statistically significant.Useing MMSE score to comparison Cognitive function,founding that preoperative and postoperative cognitive function score did not see obvious difference(P>0.05),5 minutes after extubation,A,B two groups is higher than C group(P<0.05),postoperative 1,3,7 days did not see significant difference between groups.Mo CA scores for each group of patients with different time comparison,discovered that extubation tube after 5 minutes,1,3 days postoperative were significantly decreased(P<0.05),postoperative scores improved 7 days and there was no statistically significant difference compared with preoperative(P > 0.05).To comparing preoperative Mo CA scores of three groups were no statistical difference,Mo CA score of A,B groups at the same time points after surgery is higher than group C,however,no significant difference between group A and group B.On the comparison of three groups of blood sugarpreoperative,no statistical difference between groups(P> 0.05).Respectively at different time points on the comparison of three groups,the results show that blood sugar levels in A,Bgroups were higher than group Cwith statistical significance(P<0.05),no statistical differences between A and B two groups(P > 0.05).Preoperative and postoperative renal function in patients with each comparison were no statistical difference(P>0.05).No case of lactic acidosis in this experiment.Conclusion:For smooth blood sugar control of diabetes patients,before the operation,adjustment of hypoglycemic drugs,have adverse impact on the change of cognitive functionon and perioperative blood sugar stable.Hypoglycemic drug metformin is not obvious influence on the change of cognitive function after surgery.