2型糖尿病不同血糖水平对乳腺癌根治术患者围术期指标的影响

Effect of Different Blood Glucose Levels in Type 2 Diabetes Mellitus on Perioperative Indexes of Patients Undergoing Radical Mastectomy

目的探讨2型糖尿病不同血糖水平对乳腺癌根治术患者围术期指标的影响。方法选择61例糖尿病乳腺癌患者为观察组,选择同期未合并糖尿病的乳腺癌患者85例为对照组,2组均行乳腺癌根治术。比较分析对照组及观察组不同血糖水平患者的临床资料、术中出血量、手术时间、术后引流量、术后并发症、引流管留置时间及平均住院时间;观察2组术前术后白细胞量。结果观察组的BMI及腋窝淋巴结均明显高于对照组(P <0. 05);观察组的术后引流量、术后并发症、引流管留置时间、平均住院时间均明显高于对照组(P <0. 05);观察组的术前术后白细胞量均明显高于对照组(P <0. 05)。观察组中低水平空腹血糖组的术后引流量、术后并发症、引流管留置时间、平均住院时间均明显低于中、高水平组(P <0. 05)。结论随着空腹血糖水平的增加,乳腺癌合并糖尿病患者术后的引流量、并发症、引流管留置时间及平均住院时间均显著升高,故乳腺癌合并糖尿病患者围术期应加强控制血糖,控制患者术前空腹血糖低于8. 0 mmol/l。

Objective To explore the effect of different blood glucose levels in type 2 diabetes on perioperative indexes of patients undergoing radical mastectomy. Methods Selected 61 patients with breast cancer who were admitted to our hospital as the observation group. Selected 85 patients with breast cancer who did not have diabetes in the same period as the control group.Both groups underwent radical mastectomy. The clinical data,intraoperative blood loss,operation time,postoperative drainage volume,postoperative complications,drainage tube indwelling time,and average length of stay of the observation group and control group,in which patients with different blood sugar levels were observed. The amount of white blood cells before and after surgery in both groups was observed. Results The average age,BMI,and axillary lymph nodes in the observation group were significantly higher than those in the control group( P < 0. 05). The postoperative drainage,postoperative complications,drainage tube indwelling time,and average length of stay in the observation group were significantly higher than those in the control group( P < 0. 05).The preoperative and postoperative leukocyte counts in the observation group were significantly higher than those in the control group( P < 0. 05). The postoperative drainage,postoperative complications,drainage tube indwelling time,and average length of stay in the observation group were significantly lower than those in the medium and high levels group( P < 0. 05). Conclusion With the increase of fasting blood glucose levels,drainage,complications,drainage tube indwelling time,and average length of stay of breast cancer patients with diabetes were significantly increased. Therefore,breast cancer patients with diabetes should strengthen blood glucose control during perioperative period,and control patients’ preoperative fasting blood glucose below 8. 0 mmol/L.