围手术期干预对胃癌根治术合并糖尿病患者血糖水平、心理状态及并发症的影响

Effects of perioperative intervention on blood glucose,psychological status and complications in patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer

目的探讨围手术期干预对胃癌根治术合并糖尿病患者血糖水平、心理状态及术后并发症发生情况的影响。方法根据干预方式的不同将90例胃癌根治术合并糖尿病患者分为干预组(n=45)和对照组(n=45)。对照组给予常规干预,干预组给予围手术期干预。比较两组患者干预前后的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分;比较两组患者手术前后的血糖变化情况、术后并发症发生情况及对干预模式的满意度。结果干预后,两组患者的SAS、SDS评分均低于本组干预前,且干预组患者的SAS、SDS评分均低于对照组(P﹤0.05)。术后,两组患者的血糖值均较术前升高,且于术后12 h达到峰值;干预组患者术后12、24 h的血糖值均低于对照组(P﹤0.05)。两组患者发生的术后并发症包括低血糖、切口感染、肺部感染、酮症酸中毒。干预组术后并发症的总发生率低于对照组(P﹤0.05)。干预组患者的干预满意度为97.78%(44/45),明显高于对照组患者的77.78%(35/45)(P﹤0.01)。结论围手术期干预可有效控制胃癌根治术合并糖尿病患者的血糖,降低术后并发症发生率,改善患者的心理状态,值得临床推广应用。

Objective To investigate the effects of perioperative intervention on blood glucose,psychological status and complications in patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer.Method A total of 90 patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer were divided into intervention group(n=45)and control group(n=45)according to different interventions.The patients in control group were given routine intervention while those in intervention group was given perioperative intervention.The scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)before and after the intervention were compared between the two groups,and the alternation in blood glucose,incidence of complications and satisfaction with intervention model between the two groups before and after operation were also compared.Result After the intervention,both the SAS and SDS scores of the two groups were lower than before,and scores of the intervention group were significantly lower than those of the control group(P<0.05).After the operation,the blood glucose of patients in both groups were higher than those before the operation,and reached the peak 12 hours after the operation.The blood glucose levels of patients in the intervention group were lower than those in the control group at 12 and 24 hours after operation,and the differences were statistically significant(P<0.05).Postoperative complications in either groups include hypoglycemia,incision infection,pulmonary infection and diabetic ketoacidosis.The total incidence of postoperative complications in the intervention group was significantly lower than that in the control group(P<0.05).The satisfaction with the intervention of patients in the intervention group was 97.78%(44/45),which was higher than 77.78%(35/45)in the control group(P<0.01).Conclusion Perioperative intervention could effectively control the glucose level of patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer,reduce the incidence of complications,and improve the psychological state of related patients.This method is worthy of clinical application.