大肠癌合并糖尿病36例围手术期的处理

Analysis of perioperative management of the colorectal carcinoma complicated by diabetes mellitus in the report of 36 cases

目的 探讨大肠癌并存糖尿病围手术期处理的有关问题。方法 回顾性分析 1980～ 1997年 36例大肠癌合并糖尿病病人的围手术期处理。结果 手术行肿瘤根治术 2 6例 ,姑息性手术 10例。术后伤口感染 6例 ,肺部感染 3例 ,心肌梗死 1例 ,低血糖反应 2例 ,酮症酸中毒 2例 ,术后无吻合口瘘及死亡病例。结论 对大肠癌合并糖尿病病人除了充分的准备外 ,只要围手术期严格控制血糖 。

Objective To explore the pertinent problems in the perioperative management of the colorectal carcinoma complicated by diabetes mellitus.Methods From 1980 to 1997,36 cases of the colorectal carcinoma with diabetes mellitus were analyzed retrospectively concerning their perioperative management.Results 26 cases underwent radical resection while 10 cases received palliative resection.Postoperative complications were wound infection(6 cases),pneumonia(3 cases),myocardial infarction(1 case),hypoglycemic reaction(2 cases),and diabetic ketoacidosis(2 cases).There were no anastomotic leak and operative death.Conclusion If the patient's blood glucose concentration in perioperactive period can be well controlled and the method of operation is selected reasonably,with full preoperative preparation,the effect of surgical treatment on the colorectal carcinoma with diabetes mellitus will be very gratified.