垂体腺瘤合并糖尿病的围手术期处理

Perioperational management of pituitary adenoma patients complicated with diabetes mellitus

目的 总结垂体腺瘤合并糖尿病病人的围手术期处理经验，并对有关问题进行探讨。方法 对４３例合并糖尿病的垂体腺瘤病人在围手术期间严密监测血糖、尿糖，术前术后在饮食疗法的基础上口服降糖药物和皮下注射胰岛素，术中持续静脉输注胰岛素，同时使用有效的抗生素预防感染和加强营养支持治疗。结果 无并发症者３６例，伤口感染延期愈合３例，并发肺部感染２例，颅内感染２例，酮症酸中毒１例，死亡１例。结论 垂体腺瘤合并糖尿病病人围手术期处理关键在于术前和术中血糖控制。

Objective To summarize the experience of managing the pituitary adenoma patients complicated with diabetes mellitus(PAPCDM)in the perioperational period,and to study some related respects.Methods In 43 cases of PAPCDM,in the perioperational period authors conducted intensive monitoring their blood and urine glucose,gave diet therapy,antidiabetic agents and insulin to control blood glucose,and provided sufficient and effective antibiotics to prevent infection,and nutritional supports as well.Results There were 36 cases with no complications,3 cases with wound infection,2 cases with lung infection,1 case with intracranial infection,1 case with diabetic ketoacidosis,1 case died.Conclusion The key measures are controlling the blood glucose of PAPCDM in preoperational and operational periods.