非糖尿病患者腹腔镜胃癌根治术后高血糖状态与术后感染的相关性分析

Analysis on the correlation between hyperglycemia and postoperative infection in non-diabetic patients after laparoscopic radical resection of gastric cancer

目的探讨术前非糖尿病患者腹腔镜胃癌根治术后高血糖状态与术后感染的关系。方法回顾性分析中国科学院大学附属肿瘤医院2016年1月~2018年12月行腹腔镜胃癌根治术,既往无糖尿病史的患者,按照术后48 h内所检测获得的最高血糖值,将患者分为正常血糖组(血糖<7.0 mmol/L)、轻中度高血糖组(血糖7.0~11.0 mmol/L)和重度高血糖组(血糖>11.0 mmol/L),分析术后高血糖对术后感染的影响。结果本研究中59.9%(106/177)非糖尿病患者在术后48 h内出现血糖升高,术后感染发生率:正常血糖组4.2%(3/71),轻中度高血糖组7.3%(6/82),重度高血糖组33.3%(8/24),术后感染发生率组间比较差异有统计学意义(P<0.05)。结论非糖尿病患者在胃癌根治术后血糖升高很常见,术后48 h血糖水平与术后感染发生有一定相关性。

Objective To explore the relationship between postoperative hyperglycemia and postoperative infection in non-diabetic patients undergoing laparoscopic radical resection of gastric cancer.Methods The patients with no previous history of diabetes who underwent laparoscopic radical resection for gastric cancer from January 2016 to December 2018 in Cancer Hospital of the University of Chinese Academy of Sciences were retrospectively analyzed.According to the highest blood glucose value detected within 48 hours after surgery,the patients were divided into normal blood glucose group(blood glucose<7.0 mmol/L),mild to moderate hyperglycemia group(blood glucose 7.0~11.0 mmol/L)and severe hyperglycemia group(blood glucose>11.0 mmol/L).The effect of postoperative hyperglycemia on postoperative infection was analyzed.Results In this study,59.9%(106/177)non-diabetic patients experienced an increase in blood glucose within 48 hours after surgery.Postoperative infection rate was 4.2%(3/71)in the normal blood glucose group,7.3%(6/82)in the mild to moderate hyperglycemia group,and 33.3%(8/24)in the severe hyperglycemia group.There was a significant difference in the incidence of postoperative infection between groups(P<0.05).Conclusion It is common for non-diabetic patients to have elevated blood glucose after radical resection of gastric cancer.There is a certain correlation between the 48 h postoperative blood glucose level and the occurrence of postoperative infection.