岭南现代临床外科
嶺南現代臨床外科
령남현대림상외과
LINGNAN MODERN CLINICS IN SURGERY
2014年
3期
260-263
,共4页
周军%褚忠华%伍衡%刘璐%罗兴喜%曾育杰
週軍%褚忠華%伍衡%劉璐%囉興喜%曾育傑
주군%저충화%오형%류로%라흥희%증육걸
糖尿病%围手术期处理
糖尿病%圍手術期處理
당뇨병%위수술기처리
Diabetes mellitus%Perioperative management
目的：探讨糖尿病病人胃肠手术围手术期的处理经验。方法对2009年5月至2013年2月间，我科63例合并糖尿病的胃肠外科手术病人围手术期治疗进行回顾性分析，比较高血糖单因素对手术并发症和死亡率的影响以及血糖控制的临床意义。结果63例中择期手术11例，限期手术45例，急症手术7例。治愈率88．30％（55/63），好转率9．52％（6/63），病死率3．17％（2/63）。糖尿病组手术后多数并发症与感染有关，感染相关并发症占比68．00％（17/25），其中手术切口感染最常见，其次为泌尿系感染和肺部感染；最严重的并发症为术后败血症、高糖高渗非酮性昏迷、酮症酸中毒和心肺功能不全，围手术期病人的死亡均与这些并发症有关。结论合并糖尿病的胃肠外科手术风险增大，易出现并发症，正确掌握围手术期的处理原则和方法，有利于病人平稳渡过手术及降低术后并发症的发生率。
目的：探討糖尿病病人胃腸手術圍手術期的處理經驗。方法對2009年5月至2013年2月間，我科63例閤併糖尿病的胃腸外科手術病人圍手術期治療進行迴顧性分析，比較高血糖單因素對手術併髮癥和死亡率的影響以及血糖控製的臨床意義。結果63例中擇期手術11例，限期手術45例，急癥手術7例。治愈率88．30％（55/63），好轉率9．52％（6/63），病死率3．17％（2/63）。糖尿病組手術後多數併髮癥與感染有關，感染相關併髮癥佔比68．00％（17/25），其中手術切口感染最常見，其次為泌尿繫感染和肺部感染；最嚴重的併髮癥為術後敗血癥、高糖高滲非酮性昏迷、酮癥痠中毒和心肺功能不全，圍手術期病人的死亡均與這些併髮癥有關。結論閤併糖尿病的胃腸外科手術風險增大，易齣現併髮癥，正確掌握圍手術期的處理原則和方法，有利于病人平穩渡過手術及降低術後併髮癥的髮生率。
목적：탐토당뇨병병인위장수술위수술기적처리경험。방법대2009년5월지2013년2월간，아과63례합병당뇨병적위장외과수술병인위수술기치료진행회고성분석，비교고혈당단인소대수술병발증화사망솔적영향이급혈당공제적림상의의。결과63례중택기수술11례，한기수술45례，급증수술7례。치유솔88．30％（55/63），호전솔9．52％（6/63），병사솔3．17％（2/63）。당뇨병조수술후다수병발증여감염유관，감염상관병발증점비68．00％（17/25），기중수술절구감염최상견，기차위비뇨계감염화폐부감염；최엄중적병발증위술후패혈증、고당고삼비동성혼미、동증산중독화심폐공능불전，위수술기병인적사망균여저사병발증유관。결론합병당뇨병적위장외과수술풍험증대，역출현병발증，정학장악위수술기적처리원칙화방법，유리우병인평은도과수술급강저술후병발증적발생솔。
Objective To report the perioperative experience in handling the diabetic patients underwent gastrointestinal surgery...Methods During May 2009 to February 2013,.the perioperative treatment of 63 cases accepted gastrointestinal surgery combined diabetic patients were retrospectively analyzed..The hyperglycemia univariate were compared against surgical complications and mortality. The clinical significance of glycemic control were assessed....Results Among the 63 cases,.elective surgery were 11 cases, the deadline for surgery were 45 cases and seven cases were emergency surgery. Cure rate were 88.30% (55/63), improvement rate of were 9.52% (6/63),.the fatality rate were 3.17%. (2/63).. Most surgical complications were associated with post-operative infection ,.accounting for 68.00% (17/25),.the incision infection were the most common,.followed by urinary tract infections and lung infections. The most serious complications were postoperative sepsis ,.high sugar hyperosmolar nonketotic coma, ketoacidosis and cardiopulmonary dysfunction..Perioperative patient deaths were associated with these complications....Conclusion Diabetes increases the risk of gastrointestinal surgery,.prone to complica-tions..To perioperative correctly grasp, the principles and methods of treatment will benefit the patient to smooth out the surgery. And the incidence of postoperative complications may be greatly reduced.
