糖尿病患者胸部手术围术期血糖控制50例分析

Perioperative Management of Thoracic Surgery in Patients with Diabetes Mellitus:Clinic Analysis of 50 Cases

目的探讨糖尿病患者胸部手术围术期血糖的控制及其对手术的影响。方法回顾性分析50例胸部肿瘤并糖尿病患者接受胸科术治疗围术期的血糖调控情况。50例患者分别接受肺叶切除术、全肺切除术、肺楔形切除术、支气管袖形切除术、余肺切除术、食管贲门癌切除胃代食管术、纵隔肿瘤切除术及全胸骨切除术等复杂胸科手术治疗,术前、术中及术后分别控制血糖。结果50例患者入院时空腹血糖平均(9·2±1·4)mmol/L,术后第1、2、3d平均血糖分别为(11·6±1·0)mmol/L、(10·2±1·0)mmol/L、(9·5±0·7)mmol/L;并发术后感染5例次,吻合口瘘1例,肺功能不全、呼吸机支持2例,并发症发生率为16·0%,死亡率为2·0%。结论糖尿病患者经正确的围术期处理,将血糖维持至基本正常水平,可耐受复杂的胸部手术。

Objective To evaluate the perioperative blood glucose control on thoracic surgery in the patients with diabetes meUitus. Methods The blood glucose control during perioperative period in 50 cases with diabetes mellitus who had accepted the thoracic surgery were analysed retrospectively. Results The average fasting blood glucose level of 50 cases on admission was （9. 2± 1.4） mmol/L and was controlled to （7. 0 ±1.0） mmol/L before operation, during operation and postoperation, the blood glucose was controlled about （8.0 ± 1.1 ） mmol/L. Results Complications were occurred wound infection in 5, anastmosis leak in 1, respiratory failure in 2 and death in 1. The morbidity in the patients with diabetes mellitus was about 16%, and mortality was 2%. Conclusion The patients with diabetes mellitus can accept complicated thoracic surgery after controlling the blood glucose level with properly perioperative treatment.