糖尿病对腹部手术患者刀口愈合的影响

Effect of Diabetes Mellitus on the Healing of Incision in Patients with Ab-dominal Operation

目的糖尿病对腹部手术患者刀口愈合的影响。方法选取2011年1月—2015年1月在该院行腹部手术的70例糖尿病患者作观察组,随机抽取同期诊治的非糖尿病行腹部手术者70例作为对照组。两组择期手术患者进行充分术前准备,所有糖尿病患者静脉滴注胰岛素,控制空腹血糖在7 mmol/L、餐后2 h血糖在9 mmol/L左右,麻醉满意后实施腹部手术,术毕后对切口进行缝合。整个手术过程严格按照手术标准操作,对糖尿病患者时刻监控患者的血糖变化情况控制在稳定水平,术后继续注射胰岛素调节血糖,至能正常饮食后该用术前降糖方案。观察两组患者切口愈合情况及住院时间。结果观察组平均住院时间为(11.32±3.24)d,对照组为(7.14±2.15)d,观察组住院时间长于对照组,P<0.05。观察组切口愈合甲级52例(74.3%),乙级3例(4.3%),丙级15例(21.4%),丙级愈合率为21.4%;对照组切口愈合甲级67例(95.7%),乙级1例(1.4%),丙级2例(2.9%),丙级愈合率为2.9%,观察组切口丙级愈合率高于对照组,P<0.05。结论糖尿病是影响腹部手术患者刀口愈合的危险因素,良好的血糖控制有助于降低腹部手术的糖尿病患者刀口愈合不良的发生率。

Objective To investigate the effect of diabetes on the healing of incision in patients with abdominal operation.Methods 70 patients with diabetes who underwent abdominal surgery in our hospital from Jan 2011 to 01 months in our hospital were selected as the control group, and 70 patients with diabetes mellitus were randomly selected as the control group. Two groups of patients undergoing elective surgery patients with adequate preoperative preparation, all the patients with diabetes intravenous infusion of insulin, fasting blood glucose control in the 7mmol/L, 2 hours after the meal 9mmol/L,anesthesia satisfaction after the implementation of abdominal surgery, postoperative incision suture. The whole operation process strictly according to the operation standard operation, the patients with diabetes mellitus at the time of the control of blood glucose level of control at the level of stability, and continue to inject insulin to adjust blood sugar, to the normal diet after the use of the method of pre operation. To observe the healing of wound and the length of hospital stay in the two groups. Results the average length of hospital stay was（11.32±3.24） days, the control group was（7.14±2.15） days, the observation group was longer than the control group, P〈0.05. To observe the incision group of 52 cases of grade a healing（74.3%）, B in 3 cases（4.3%）, C in 15 cases（21.4%）, C healing rate was 21.4%; control group, incision healing class 67cases（95.7%）, grade B in 1 cases（1.4%）, C in 2 cases（2.9%）, C healing rate was 2.9%, observe incision group in Grade C healing rate was higher than that of control group, P〈0.05. Conclusion diabetes is a risk factor of influence in patients undergoing abdominal operation incision healing and good glycemic control is useful in lower abdominal surgery in diabetic patients with incision healing bad incidence.