结直肠癌合并糖尿病患者围手术期治疗32例报告

Perioperative treatment of patients with colorectal cancer and diabetes

目的探讨结直肠癌合并糖尿病患者的围手术期治疗方法。方法回顾性分析32例结直肠癌合并糖尿病患者的临床资料。结果32例患者均行手术治疗，其中根治性手术30例、结肠造瘘手术2例。术前空腹血糖控制在6．0～8．0mmol／L，餐后血糖≤11．1mmol／L，术后血糖维持在6．0～10．0mmol／L。术后并发肺部感染4例，吻合1：3瘘1例，切口裂开2例，切口液化感染3例，心功能衰竭2例，结肠残端糜烂出血1例，其中2例切口裂开、1例心功能衰竭均合并肺部感染，所有病例均顺利度过围手术期。结论合理使用胰岛素，严格监测、控制血糖，完善妥当地处理结直肠癌合并糖尿病患者，能够安全度过围手术期。

Objective To explore the perioperative treatment of patients with colorectal cancer and diabetes. Method The clinical data of 32 patients with colorectal cancer and diabetes were summarized and analyzed retrospectively. Results Thirty-two patients had undergone surgical treatment. Of them, 30 had received radical surgery, 2 had received celostomy. Before surgery, the fasting blood sugar was controlled at 6.0-8.0mmol/L, and the postprandial blood sugar was ≤ 11.1 mmol/L. After the surgery, the blood sugar was maintained at 6. 0-10. 0 mmol/L. After the surgery, complication of lung infection occurred in 4 patients, fistula at anastomosis ~curred in 1 patient, the incision margins splited in 2 patients, the incision margins liquefied and were infected in 3 patients, the heart function failure occurrced in 2 cases, the colon remnant end eroded and bled in 1 case. Among these patients, 2 with incision margin split and 1 with heart function failure were complicated with lung infection. All patients passed smoothly the perioperative period. Conclusion The reasonable use of insulin, strictly monitoring and controlling blood sugar, perfect and appropriate managing can make the patients with colorectal cancer and diabetes spend the perioperative period safely.