合并糖尿病的普外手术病人围手术期治疗体会

The perioperative management of the general surgery complicated with diabetes mellitus

目的探讨合并糖尿病的普外手术病人围手术期的治疗措施。方法对1995年至2006年我院普外科收治的54例合并糖尿病的普外手术病人的临床资料作回顾性分析。结果54例病人均为2型糖尿病,其中择期手术33例,限期手术3例,应用胰岛素将术前空腹血糖控制在6.5-10.1mmol/L;急诊手术18例,术前空腹血糖控制在8.5-13.5mmol/L,术中血糖控制在8.5-13.5mmol/L,术后血糖控制在8.0mmol/L以下。术后出现2例切口感染,1例肺部感染,1例泌尿系感染,无酮症酸中毒及死亡病例。结论严格控制血糖,尽量减少手术时间,选择合适的麻醉方式有利于合并糖尿病的普外手术病人安全度过围手术期。

Objective To explore the perioperative management of the general surgery complicated with diabetes mellitus.Methods From 1995 to 2006,the clinical data of 54 patients complicated with diabetes mellitus performed general surgery in our hospital were analyzed retrospectively.Results The associated diabetes of these 54 cases were all type 2.33 cases were subjected elective operation,and 3 cases were time limited operation.The preoperative fasting blood-glucose was controlled within 6.5-10.1mmol/L.The remaining 18 cases received emergency operation.The preoperative fasting blood-glucose was controlled within 8.5-13.5mmol/L.The intraoperative blood-glucose was controlled within 8.5-13.5mmol/L.The postoperative fasting blood-glucose was controlled under 8.0mmol/L.The morbidity of postoperative complication:incision infection in 2 cases,pneumonia in 1 case.There was no postoperative diabetic ketoaccidosis and operative death.Conclusion If the patient's blood-glucose concentration could be well controlled,the period of operation could be lessoned and the anesthesia were selected reasonably,it would be beneficial and safe to the patients in the perioperarative period.