糖尿病患者合并手术疾病的现状调查分析

Investigation and analysis of the status quo of diabetes patients complicated with surgical diseases

目的了解糖尿病(DiabetesMellitus,DM)患者合并手术治疗的疾病谱分布状况及代谢指标情况。方法回顾性分析2020年1月-12月青岛市城阳人民医院住院2020例DM患者,其中DM伴手术(手术组)640例,DM不伴手术(非手术组)1380例,统计并分析DM患者合并各类手术的现状及代谢指标控制情况。结果与非手术组相比,手术组糖化血红蛋白(HbA1C)、甘油三酯(TG)、空腹血糖(FBG)、体质量指数(BMI)及尿微量白蛋白/肌酐(UACR)均高于前者,差异有统计学意义(P<0.05),而白蛋白低于前者,差异有统计学意义(P<0.05)。DM患者伴手术疾病中排名前五位的疾病谱分别为拔牙(18.91%)、椎间盘突出症和狭窄症(14.37%)、白内障(12.50%)、消化道肿瘤和息肉(9.25%)及肛周脓肿(8.75%)。多因素非条件logistic回归分析显示年龄、病程、糖化血红蛋白(HbA1C)、空腹血糖(FBG)及BMI与DM并发手术疾病呈正相关,(OR=4.574、1.956、1.148、2.426、1.452)。结论DM伴手术患者血糖、BMI、TG更高,白蛋白更低,DM伴手术疾病谱常见拔牙、椎间盘突出症和狭窄症、白内障、消化道肿瘤和息肉及肛周脓肿。年龄大、病程长、高BMI及血糖控制不佳的糖尿病患者易于伴发手术疾病。

Objective To understand the disease spectrum distribution and metabolic indicators of diabetes patients with surgery.Methods A retrospective analysis was conducted on 2020 DM patients admitted to Qingdao Chengyang People's Hospital from January to December 2020,including 640 cases of DM with surgery(surgical group)and 1380 cases of DM without surgery(non surgical group).Statistics and analysis of the current situation of DM patients undergoing various surgeries and the control of metabolic indicators.Results Compared with the non-surgical group,Glycated hemoglobin,TG,Fasting blood glucose,body mass index,and urinary microalbumin/creatinine in the surgical group were higher than those in the non-surgical group,with a statistically significant difference(P<0.05),while albumin was lower than the former,with a statistically significant difference(P<0.05).The top five disease spectrum of DM patients with surgical diseases were tooth extraction(18.91%),Spinal disc herniation,and stenosis(14.37%),respectively Cataracts(12.50%),gastrointestinal tumors and polyps(9.25%),and perianal abscesses(8.75%).Multivariate unconditional logistic regression analysis showed a positive correlation between age,course of disease,glycosylated hemoglobin(HbA1C),fasting blood glucose(FBG),and BMI with surgical complications in DM(OR=4.574,1.956,1.148,2.426,1.452).Conclusions Patients with DM accompanied by surgery have higher blood sugar,BMI,TG,and lower albumin levels.The disease spectrum of DM accompanied by surgery is common-ly characterized by tooth extraction,intervertebral disc herniation and stenosis,cataracts,gas-trointestinal tumors,polyps,and perianal abscesses.Patients with diabetes who are old,have a long course of disease,high BMI,and have poor blood glucose control are prone to surgical disea-ses.