目的 研究完全腹膜外腹腔镜腹股沟疝修补术对睾丸血流灌注及体积的影响。 方法 2009年7月-2011年5月,对62例行完全腹膜外腹腔镜单侧腹股沟疝修补术男性患者进行自身前后对照研究,比较术前、术后患侧睾丸的睾丸动脉(TA)、睾丸包膜动脉(CA)、睾丸内动脉(ITA)血流参数[收缩期峰值血流速度(PSV)、舒张未期血流速度(EDV)及血管阻力指数(RI)]、睾丸体积(TV)及血清睾酮的变化情况。 结果 患者获随访7~24个月,平均15.6个月,无复发患者。术前及术后3、6个月时患侧TV分别为(9.91 ± 3.72)、(10.23 ± 4.18)和(10.16 ± 3.94)cm3,同期血浆睾酮水平分别为(544.25 ± 123.72)、(532.89 ± 145.66)和(565.65 ± 138.13)μg/L,手术前后比较患侧TV(F=1.350,P=0.263)、血浆睾酮水平(F=1.673,P=0.192)无统计学意义,血浆睾酮水平均在正常范围内。术后3、6个月患侧TA、CA和ITA的EDV明显高于术前,RI较术前明显降低,差异均有统计学意义(P<0.05);PSV与术前比较差异无统计学意义(P>0.05)。术后3个月患侧睾丸各动脉PSV、EDV、RI与术后6个月比较差异无统计学意义(P>0.05)。 结论 完全腹膜外腹腔镜腹股沟疝修补术后患侧睾丸血流灌注情况可能会有所改善,不影响TV及血清睾酮水平。
Objective To explore the relationship between preoperative fasting plasma glucose (FPG) and postoperative pulmonary complications (PPCs) in type 2 diabetic patients undergoing elective thoracoscopic lung resection, and provide a reference for prediction and prevention of PPCs in the clinic. Methods A retrospective analysis was performed on the type 2 diabetic patients who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2017 to March 2021. According to the level of FPG one day before the operation, the patients were divided into three groups: a hypoglycemia group (<6.1 mmol/L), a medium level blood glucose group (≥6.1 mmol/L and <8.0 mmol/L) and a high blood glucose group (≥8.0 mmol/L). Besides, the patients were divided into a PPCs group and a non-PPCs group according to whether PPCs occurred. The risk factors for PPCs were analyzed by logistic regression analysis, and the predictive value of preoperative FPG level on PPCs was estimated by the area under the receiver operating characteristic curve (AUC). Results A total of 130 patients were included, including 75 (57.7%) males and 55 (42.3%) females with an average age of 63.5±9.0 years. Logistic regression analysis showed that compared to non-PPCs patients, the level of preoperative FPG (P=0.023) and smoking history ratio (P=0.036) were higher and the operation time was longer (P=0.004) in the PPCs patients. High FPG level on preoperative day 1 and longer operation time were associated with PPCs risk. Besides, the preoperative FPG of 6.79 mmol/L was the threshold value to predict the occurrence of PPCs [AUC=0.653, 95%CI (0.559, 0.747), P=0.003]. Conclusion There is a certain correlation between preoperative FPG level and postoperative PPCs, which may be used as an index to predict the occurrence of PPCs.