摘要
目的 对食管癌、贲门癌伴有糖尿病的患者如何在围手术期中血糖的调控及并发症的处理进行分析评价。方法 将这类患者以血糖 13 .8mmol L为界分成两组 ,Ⅰ组术前 1d将口服降糖药物改用普通胰岛素 ,Ⅱ组术前 3d改用。按 1U胰岛素加 4～ 5g糖的比例补液 ,尿糖 (+ )不用胰岛素 ,每增加 1个加号按 5U胰岛素剂量追加。结果 术后并发吻合口瘘 8.8%、肺部感染 2 6.5 %、切口感染11.8%、尿路感染 2 .9% ,高于正常患者 ,尤其是Ⅱ组比Ⅰ组发生率高 (P <0 .0 5 )。结论 食管癌、贲门癌合并糖尿病不是手术禁忌证 ,但术后易发生并发症 。
Objective To analyze and evaluate the control of blood sugar and the treatment of complications in patients with esophagocardial carcinoma accompanied by diabetes in perioperative period.Methods The patients were divided into 2 groups,i.e.Group Ⅰ(blood sugar≥13.8 mmol/L) and Group Ⅱ(blood sugar>13.8 mmol/L).Regular insulin(1 U of insulin plus 4～5 g of glucose) was intravenously given to patients in Group Ⅰ and Group Ⅱ to replace oral hypoglycemic agents 1 day and 3 days before operation respectively.When urine sugar was a plus sign(+),insulin was not given;whenever urine sugar was increased by a plus sign(+),5 U of insulin was added.Results In postoperative complications,anastomotic leakage,pulmonary infection,incisional infection and urinary tract infection were 8.8%,26.5%,11.8% and 2.9% respectively,which were higher than normal levels;especially,Group Ⅱ had higher incidence of postoperative complications than Group Ⅰ(P<0.05).Conclusion Esophagocardial carcinoma complicated with diabetes is not a contraindication of surgical operation;however,in patients complicated with diabetes,postoperative complications are easy to develop.The key of successful operation is to adopt effective methods of controlling diabetes.
出处
《河北医药》
CAS
2001年第6期413-414,共2页
Hebei Medical Journal
