贲门癌并存糖尿病的围手术期处理

PERIOPERATIONAL MANAGEMENT OF CARDIAC CANCER & ITS CONCOMITANT DIABETES MELLITUS

本文报道３５例贲门癌并存糖尿病手术病人的围手术期处理情况。其中男２６例，女９例，平均年龄６２．５岁。３５例病人均在全麻下手术，根治性切除３２例，切除率９１．４％；术后并发症为２２．７％，死亡２例，吻合口瘘２例，切口感染３例。本文重点讨论贲门癌并存糖尿病手术的危险因素及术前、术中、术后对糖尿病的处理。强调围手术期监测血糖、稳定血糖浓度是减少手术并发症的关键。

This paper reports the perioperational management of 35 cases of cardiac can-cer with concomitant diabetes mellitus. Of them, there were 26 males and 9 females,withtheir age averaging 62. 5 years. Surgery performed under general anesthesia was seen in 35cases. Radical resection waxdone for 32 cases(resection rate:91.4%).A22.7%of the post-operational complications was obxerved.Death occurred in 2 cases. Anastomotic leakagehappened in 2 cases. Incisional infection emerged from 3 cases. Stress of discussion was laidon the operative risk factors for cardiac cancer and its concomitant diabetes mellitus and onthe pre,inter and post-operative management of diabetes mellitus. To perioperatively moni-tor blood sugar,a pre-operative 7～10 days'administration of regular blood-sugar-loweringtherapy (D_860 1.5～3.0/day)and an inter and postoperative proper use of insulin (RI:GS=1: 3) were carried out.These measures constituted the keys to the reduction of operativecomplications through stabilizing the concentration of blood sugar at a level of 7.5～9.5mmol/L.