| Objective: Retrospective analysis of hemodynamics and postoperative complications during tibia transverse bone transfer in diabetic and non-diabetic patients.Methods: The total number of patients receiving lateral tibial bone transfer in the first affiliated hospital of guangxi medical university from January 2014 to April 2018 was counted as 196.There were 126 diabetic patients and 70non-diabetic patients.Collect general information such as gender,age,height,weight,albumin value,chest radiograph,diagnosis of hypertension,heart disease,etc.BP and HR before the start of anesthesia,5 minutes,10 minutes,15 minutes,30 minutes,and 60 minutes after the start of anesthesia.Collect the highest and lowest BP and HR 、the use of ephedrine and the amount of fluid infusion during surgery.The postoperative hospital stay,total hospital stay,and perioperative complications during the hospitalization were collected.Divided196 patients into diabetes(n=126)and non-diabetes(n=70).Using SPSS22.0statistical software to match the gender,age,BIM,ALB,chest radiographs,diagnosis of hypertension,and heart disease in diabetic patients withnon-diabetic patients,63 pairs were matched,63 cases of diabetes(group A)and non-diabetes(group B).The matched diabetic patients were divided into A1group(general anesthesia group,n=24)and A2 group(neuro block anesthesia group,n=39)according to different anesthesia methods.Non-diabetic patients were divided into B1 group(general anesthesia group,n=25)and B2 group(nerve block anesthesia group,n=38)according to different anesthesia methods.Results:The patient’s gender,age,BMI,ALB,chest radiograph,hypertension,heart disease,and anesthesia were matched by statistical methods using propensity matching analysis.There were 63 pairs of matched cases,3cases of diabetic and non-diabetic patients,the general data were not statistically different after matching(P>0.05).The intraoperative use rate of ephedrine in group A(30.2%)was higher than that in group B(17.7%),the intraoperative use rate of urapidil in group A(3.2%)was lower than group B(11.1%),the HR of group B was faster than group A(P< 0.05),the HR of group B was fastand the total days of hospitalization of group A(20±10)were longer than group B(17±8).The intraoperative incidence of blood transfusion group A(14.3%)was higher than group B(7.9%),there were 4 cases(4.7%)of postoperative complications group A,and 2 cases(3.2%)of group B.Intraoperative hemodynamic fluctuation of group A1 was greater than group A2(P < 0.05),intraoperative infusion was significantly higher than group A2(P< 0.05),total hospital stay of group A1(22±9)was longer than group A2(19±10)(P < 0.05),and intraoperative ephedrine utilization rate of group A1 was 75% higher than group A2(2.6%)(P < 0.05).B1 intraoperative hemodynamic fluctuations than the B2 group(P < 0.05),the amount of intraoperative infusion B1 group was obviously higher than B2 group(P < 0.05),group B1(9±7)for postoperative hospital stay longer than the group B2(7±5),B1 group(25±20)for the totallength of hospital stay longer than the group B2(15± 6),B1(36%)intraoperative use of methamphetamine rate is higher than B2(5%),B1(16%)intraoperative blood transfusion rate is higher than B2 group(2.6%).Conclusion:Compared with non-diabetic patients,patients with diabetes mellitus underwent lateral tibial bone removal with significant intraoperative easterly flow.Femoral nerve combined with sciatic nerve block is more suitable for transversal-tibial bone transfer surgery in patients with diabetes and non-diabetes mellitus. |
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