糖尿病合并胰腺癌控制血糖对胰十二指肠切除术后早期并发症的影响分析

Influence of Glycemic Control on Early Complications after Pancreatico⁃duodenectomy in Patients with Diabetes and Pancreatic Cancer

目的分析糖尿病患者并发胰腺癌实施胰十二指肠切除术后,控制血糖指标平稳对早期并发症的影响。方法回顾性选取2017年2月—2023年4月乌兰察布市中心医院收治的82例患有糖尿病同时合并胰腺癌患者的临床资料,所有患者入院后均已行胰十二指肠切除术。以不同的血糖控制方法分为对照组与研究组,每组41例,对照组采取甘精胰岛素注射液治疗,研究组采取德谷门冬双胰岛素注射液治疗,对比两组患者的血糖水平以及早期并发症发生情况。结果治疗后,研究组的空腹血糖与餐后2 h血糖均低于治疗前,差异有统计学意义(P均<0.05);对照组治疗前后空腹血糖比较,差异无统计学意义(P>0.05),餐后2 h血糖则低于治疗前,差异有统计学意义(P<0.05);治疗后,研究组空腹血糖与餐后2 h血糖均低于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率(4.9%)明显低于对照组(19.5%),差异有统计学意义(P<0.05)。结论对糖尿病与胰腺癌合并患者行胰十二指肠切除术后,严格监控患者的血糖,可有效地降低术后早期并发症发生率,德谷门冬双胰岛素相较于甘精胰岛素效果更佳。

Objective To analyze the influence of stable control of blood glucose index on early complications after pancreaticoduodenectomy in diabetic patients with pancreatic cancer.Methods Clinical data of 82 patients with dia-betes combined with pancreatic cancer admitted to Ulanqab Central Hospital from February 2017 to April 2023 were retrospectively selected.All patients underwent pancreaticoduodenectomy after admission.There were 41 cases in each group.The control group was treated with insulin glargine injection,and the study group was treated with Degu aspartate double insulin injection.The blood glucose levels and early complications of the two groups were compared.Results After treatment,the fasting blood glucose and 2-hour postprandial blood glucose of the study group were lower than before treatment,and the differences were statistically significant(both P<0.05).There was no significant difference in fasting blood glucose before and after treatment in the control group(P>0.05),and the 2-hour postpran-dial plasma glucose level was lower than that before treatment,and the difference was statistically significant(P<0.05).After treatment,fasting blood glucose and 2-hour postprandial blood glucose in the study group were lower than those in the control group,and the differences were statistically significant(both P<0.05).The complication rate of the study group(4.9%)was significantly lower than that of the control group(19.5%),and the difference was statistically significant(P<0.05).Conclusion After pancreaticoduodenectomy in patients with diabetes and pancreatic cancer,strict monitoring of blood glucose can effectively reduce the incidence of early postoperative complications,and the ef-fect of Degu aspartate is better than that of insulin glargine.