老年妇科疾病合并糖尿病患者的围手术期处理

Perioperative management of elderly patients with gynecological diseases and diabetes mellitus

目的探讨老年妇科疾病合并糖尿病患者的临床特点及围手术期的处理技巧。方法回顾性分析我院2016年1月至2018年1月收取的老年妇科疾病合并糖尿病患者施行妇科手术的围手术期的处理情况。结果本组患者手术时间最短1.1小时,最长6小时,平均3.4小时。术后血糖10.11±2.79mmol/L,高于空腹血糖8.14±2.02mmol/L(P<0.01);手术时间在2小时内者16例,术后血糖10.06±3.24mmol/L,手术时间在2小时以上者26例,术后血糖11.46±3.73mmol/L,两者比较差异显著(P<0.05);42例患者中仅2例因脂肪液化致伤口愈合不良(4.76%),予以局部消毒换药后延期愈合。所有患者均痊愈出院。结论对合并糖尿病的老年妇科患者,调整围手术期血糖相对稳定、控制感染是老年糖尿病患者行妇科手术成功的关键。

Objective To summarize the perioperative management of elderly patients with gynecological diseases and diabetes mellitus. Methods To retrospectively analyze the clinical data and surgical management of 42 elderly patients with gynecological diseases and diabetes mellitus. Results The length of operation ranged between 1.1 h and 6 h,with an average of 3.4 h. The level of postoperative blood glucose was（10.11 ± 2. 79） mmol/L,which was higher than（8. 14 ± 2.02） mmol/L of the fasting blood-glucose. The averaged postoperative blood glucose was（10.06 ± 3. 24） mmol/L in 16 patients with surgical length less than 2 h,and was（11.46 ± 3. 73） mmol/L in 26 patients with surgical length over 2 h,with a significant difference（P〈0. 05）. There were 2 cases of poor wound healing as fat liquefaction,with the treatment of disinfection and dressing change on surgical incision site. Conclusion The stable postoperative blood glucose and infection control are key issues of successful surgical management for elderly patients with gynecological diseases and diabetes mellitus.