妇科疾病合并糖尿病的围手术期处理

Perioperative management of gynecological diseases combined with diabetes

目的:探讨糖尿病患者妇科围手术的处理原则。方法:分析73例糖尿病患者行妇科手术的临床资料。结果:全部病例术后24 h内血糖较术前增高。其中全麻及手术时间120 min以上对血糖的影响分别明显大于连续硬膜外麻醉及手术时间120 min以下者。所有患者均安全度过围手术期。结论:糖尿病患者术前应仔细检查并于手术前后积极治疗,保持围手术期血糖浓度相对稳定,合理使用抗生素,依具体情况选择麻醉方式,控制手术时间是手术成功的关键。

Objective： To explore the principles of the gynecological perioperative management.Methods： The clinical data of 73 gynecological patients with diabetes underwent gynecological operations in our hospital were analyzed.Results： The blood sugar levels of all the 73 patients increased within 24 h after operations.Effect of general anesthesia with operation time longer than 120min on the blood sugar levels of the patients were significantly larger than those of epidural anesthesia with operation time shorter than 120 min.All patients passed the perioperative period safely.Conclusion： The keys to successful operations in patients with diabetes are careful examination before surgery and a aggressive treatment before and after surgeries,a relatively steady blood sugar level,rational use of antibiotics,proper choose of anesthesia methods depending on the circumstances,and the control of operation time.