CAJ | 학술논문

目的探讨不同营养制剂对糖尿病患者胃癌根治术后血糖及并发症的影响。方法回顾性分析我院2010年6月～2012年6月就诊的60例行胃癌根治术的糖尿病患者临床资料，根据使用营养制剂的不同分为观察组与对照组，每组各30例，观察组术后选用瑞代进行肠内营养；对照组术行常规肠内营养并定时皮下注射胰岛素。比较两组患者术前和术后血糖变化情况及术后腹胀、腹泻、伤口感染发病情况。结果两组患者术前1d空腹血糖与餐后2 h血糖值比较，差异无统计学意义（P＞0.05）。较两组患者术后3、5及7 d空腹血及EN后血糖值，差异有统计学意义（P＜0.05）；血糖异常情况例数，观察组明显少于对照组（P＜0.05）；两组患者术后腹胀、腹泻情况较差异均无统计学意义（P＞0.05），但伤口感染情况观察组明显优于对照组（P＜0.05）。结论对于行胃癌根治术的糖尿病患者术后早期使用瑞代营养制剂，更有助于患者术后控制血糖水平，减少并发症而安全渡过围手术期，值得临床广泛应用。
목적탐토불동영양제제대당뇨병환자위암근치술후혈당급병발증적영향。방법회고성분석아원2010년6월～2012년6월취진적60례행위암근치술적당뇨병환자림상자료，근거사용영양제제적불동분위관찰조여대조조，매조각30례，관찰조술후선용서대진행장내영양；대조조술행상규장내영양병정시피하주사이도소。비교량조환자술전화술후혈당변화정황급술후복창、복사、상구감염발병정황。결과량조환자술전1d공복혈당여찬후2 h혈당치비교，차이무통계학의의（P＞0.05）。교량조환자술후3、5급7 d공복혈급EN후혈당치，차이유통계학의의（P＜0.05）；혈당이상정황례수，관찰조명현소우대조조（P＜0.05）；량조환자술후복창、복사정황교차이균무통계학의의（P＞0.05），단상구감염정황관찰조명현우우대조조（P＜0.05）。결론대우행위암근치술적당뇨병환자술후조기사용서대영양제제，경유조우환자술후공제혈당수평，감소병발증이안전도과위수술기，치득림상엄범응용。
Objective To investigate the effect of postoperative blood glucose and complications with different nutrition for patients with gastric cancer complicated with diabetes. Methods The clinical data of 60 patients with gastric cancer complicated with diabetes who were in hospital between June 2010 to June 2012 were retrospectively analyzed.All patients were divided into the control group and the experiment group according to the treatment method, each group of 30 cases. The experiment group was given fresubinTM diabetes(FD),and the control group was treated by fresubin and the ordinary insulin injection.The preoperative and postoperative blood glucose levels and the common complications of the two groups were compared. Results Compared the preoperative 1d fasting blood glucose and postprandial 2h blood glucose levels of two groups,there were no significant differences(P > 0.05). Compared with control group,the rate of pathoglycemia was lower in experiment group ,the difference had statistical significance separately(P < 0.05).The fasting blood glucose of 3, 5 and 7 days after operation and blood glucose value after EN of two groups had significant differences(P < 0.05). There were no significant differences in two groups of patients with postoperative abdominal distention and diarrhea(P > 0.05),but the wound infection in the experiment group was significantly better than the control group(P<0.05). Conclusion Regarding postoperative patients with gastric cancer complicated with diabetes,FD is better than fresubin in the early using.FD can control postoperative blood sugar levels of patients and reduce complications. It is helpful to postoperative recovery and worthy of clinical promoted application.