合并糖尿病食管贲门癌患者血糖浓度与围手术期并发症的相关性分析

Relationship Between Perioperative Blood Glucose Level and Complications in Esophagocardial Carcinoma Accompanied with Diabetes

目的探讨合并糖尿病的食管贲门癌患者围手术期血糖浓度与并发症的相关性。方法从2 500例食管癌贲门癌患者中筛选出合并糖尿病患者82例,发生以入院平均空腹血糖为界定值分为4.44~7 mmol/L和≥7 mmol/L两组(入院基线阶段)、以术前平均空腹血糖为界定值分为4.44~7 mmol/L和≥7 mmol/L两组(术前状态),以术后一周平均随机血糖为界定点分为4.44~11.1 mmol/L和≥11.1 mmol/L两组(术后状态)进行分析。结果以入院血糖为界定点分的两组、以术前平均血糖为界定点分的两组和以术后一周平均随机血糖为界定点分的两组在年龄、性别、肿瘤类型、术前合并慢性疾病,手术方式,营养给予方式等方面无统计学差异。入院基线阶段两组术后并发症的发生率无统计学差异(P>0.05);术前血糖控制良好组明显降低了肝损害、电解质紊乱、心律失常、感染和吻合口瘘的发生率(P<0.05);术后血糖控制良好组明显降低了肝损害、电解质紊乱,感染和吻合口瘘的发生率(P<0.05)。结论合并糖尿病的食管贲门癌患者,有效控制患者围手术期的血糖,可以降低患者术后并发症的发生率。

Objective To investigate the relationship between perioperative blood glucose level and complications in esophagocardial carcinoma accompanied with diabetes. Methods 82 patients accompanied with diabetes were selected from 2500 esophagocardial cacinoma patients who undergo thoracotomy. All the patients were grouped by admission fasting blood glucose( FBG) level 7. 0 mmol/L,preoperative fasting blood glucose level 7. 0 mmol/L and postoperative average casual blood glucose( CBG) level 11. 1 mmol/L respectively. Results The analysis showed there was no statistically significant differences between the groups in terms of age,gender,tumor type,preoperative chronic disease,surgical method,way of nutrition. There were no significant statistically differences in postoperative complications grouped by admission FBG level 7. 0 mmol / L( P > 0. 05); The group of preoperative FBG level less than 7. 0 mmol / L reduced liver dysfunction. electrolyte disorders. Arrhythmia. infection morbidity and anastomotic leakage morbidity significantly( P < 0. 05); The group of postoperative average CBG level less than 11. 1mmol / L reduced liver dysfunction. electrolyte disorders,infection morbidity and anastomotic leakage morbidity significantly( P <0. 05). Conclusion By control perioperative blood glucose of esophagocardial carcinoma accompanied with diabetes,we may reduce postoperative complications.