糖尿病对乳腺癌患者外科手术的影响

Impact of Diabetes Mellitus on the Surgery in Patients with Breast Cancer

[目的]探讨糖尿病对乳腺癌患者外科手术的影响。[方法]选取广西医科大学附属肿瘤医院2004年1月至2014年9月收治的合并2型糖尿病的乳腺癌患者,行改良根治术的78例作为观察组,按照1∶2比例随机选取156例施行改良根治术的非糖尿病乳腺癌患者作为对照组,比较分析两组患者的临床特点以及与手术治疗相关的临床指标。[结果]与对照组相比,观察组患者术后引流量、引流管留置天数、平均住院时间、术后并发症均明显增多,差异具有统计学意义(P<0.01);然而手术时间、术中失血量较对照组增多,但差异无统计学意义(P>0.05)。糖尿病患者中,术前空腹血糖<8.0mmol/L组术后引流量、引流管留置天数、平均住院时间、术后并发症均明显低于空腹血糖>8.0mmol/L组,差异具有统计学意义(P<0.01)。[结论]糖尿病会增加乳腺癌患者的术后引流量、术后并发症,延长引流时间及住院天数。术前空腹血糖控制在8.0 mmol/L以下是保证手术效果、减少术后并发症的关键。

[Purpose] To explore the impact of diabetes mellitus on the surgery of breast cancer patients. [Methods] Seventy-eight 78 cases of breast cancer patients with type 2 diabetes from Affiliated Tumor Hospital of Guangxi Medical University underwent modified radical mastectomy be-tween January 2004 and September 2014 as the observational group. And 156 cases of breast cancer patients without diabetes underwent modified radical mastectomy at the same time were randomly selected as the control group according to the proportion of 1 ∶2. Clinical characteristics and surgical treatment related clinical indicators of the patients were compared between the two groups.[Results] Compared to the control group,the postoperative drainage amounts,drainage tube indwelling duration,average days of hospitalization and wound complications in the breast cancer patients with diabetes mellitus increased significantly（P〈0.01）.The operative time and intraoperative blood loss in diabetes mellitus group were more those in the control group,but with no statistically significant difference（P〉0.05）. As for the diabetes mellitus group,patients with preoperative fasting blood glucose below 8.0mmol/L presented significant advantages in decreasing the postoper-ative drainage amounts,drainage tube indwelling duration,average days of hospitalization and wound complications when compared to whose preoperative fasting blood glucose above 8.0mmol/L group（P 〈0.01）. [Conclusion ] Diabetes mellitus may increase the postoperative drainage,wound complications and prolong drainage tube indwelling duration and average days of hospitalization in patients with modified radical mastectomy. Controlling the preoperative fasting blood glucose below8.0mmol/L is the key to reduce postoperative complications and to ensure the effect of modified radical mastectomy.