中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2014年
4期
227-229
,共3页
胰腺肿瘤%糖尿病%血糖%手术后并发症%预后
胰腺腫瘤%糖尿病%血糖%手術後併髮癥%預後
이선종류%당뇨병%혈당%수술후병발증%예후
Pancreatic neoplasms%Diabetes mellitus%Blood glucose%Postoperative complications%Prognosis
目的 探讨血糖水平与胰腺癌合并糖尿病患者术后恢复的关系.方法 根据血糖控制水平,将68例胰腺癌合并糖尿病术后患者分为强化组(血糖控制在4.4～6.1 mmol/L)和对照组(血糖控制在6.1～11.1 mmol/L),各34例.检测术后1、3、7d的空腹血糖(FBG)、空腹胰岛素定量(FINS)及C反应蛋白(CRP)水平,分析两组患者术后恢复情况及并发症发生情况.结果 强化组术后3d的FBG、FINS、CRP水平分别为(6.94±0.94) mmol/L、(17.38 ± 7.37) mmol/L、(108.33±37.25) mg/L,对照组分别为(7.81±1.36) mmol/L、(23.73±8.25) mmol/L、(131.51±42.34) mg/L,强化组较对照组显著降低,差异均有统计学意义(P值均＜0.05).强化组患者术后发热时间、排气时间、抗生素使用时间分别为(1.4±0.8)、(3.1±0.7)、(2.5 ±0.5)d,显著少于对照组的(2.5±1.1)、(4.6±0.8)、(3.7 ±0.8)d,差异均有统计学意义(P值均＜0.05).强化组切口感染率显著低于对照组(5.9％比23.5％,P＜0.05),其他术后并发症发生率及病死率与对照组比较差异无统计学意义.结论 强化血糖控制可改善胰腺癌合并糖尿病患者术后胰岛素抵抗,减轻术后的炎性反应,促进患者恢复,且不增加术后并发症的发生率.
目的 探討血糖水平與胰腺癌閤併糖尿病患者術後恢複的關繫.方法 根據血糖控製水平,將68例胰腺癌閤併糖尿病術後患者分為彊化組(血糖控製在4.4～6.1 mmol/L)和對照組(血糖控製在6.1～11.1 mmol/L),各34例.檢測術後1、3、7d的空腹血糖(FBG)、空腹胰島素定量(FINS)及C反應蛋白(CRP)水平,分析兩組患者術後恢複情況及併髮癥髮生情況.結果 彊化組術後3d的FBG、FINS、CRP水平分彆為(6.94±0.94) mmol/L、(17.38 ± 7.37) mmol/L、(108.33±37.25) mg/L,對照組分彆為(7.81±1.36) mmol/L、(23.73±8.25) mmol/L、(131.51±42.34) mg/L,彊化組較對照組顯著降低,差異均有統計學意義(P值均＜0.05).彊化組患者術後髮熱時間、排氣時間、抗生素使用時間分彆為(1.4±0.8)、(3.1±0.7)、(2.5 ±0.5)d,顯著少于對照組的(2.5±1.1)、(4.6±0.8)、(3.7 ±0.8)d,差異均有統計學意義(P值均＜0.05).彊化組切口感染率顯著低于對照組(5.9％比23.5％,P＜0.05),其他術後併髮癥髮生率及病死率與對照組比較差異無統計學意義.結論 彊化血糖控製可改善胰腺癌閤併糖尿病患者術後胰島素牴抗,減輕術後的炎性反應,促進患者恢複,且不增加術後併髮癥的髮生率.
목적 탐토혈당수평여이선암합병당뇨병환자술후회복적관계.방법 근거혈당공제수평,장68례이선암합병당뇨병술후환자분위강화조(혈당공제재4.4～6.1 mmol/L)화대조조(혈당공제재6.1～11.1 mmol/L),각34례.검측술후1、3、7d적공복혈당(FBG)、공복이도소정량(FINS)급C반응단백(CRP)수평,분석량조환자술후회복정황급병발증발생정황.결과 강화조술후3d적FBG、FINS、CRP수평분별위(6.94±0.94) mmol/L、(17.38 ± 7.37) mmol/L、(108.33±37.25) mg/L,대조조분별위(7.81±1.36) mmol/L、(23.73±8.25) mmol/L、(131.51±42.34) mg/L,강화조교대조조현저강저,차이균유통계학의의(P치균＜0.05).강화조환자술후발열시간、배기시간、항생소사용시간분별위(1.4±0.8)、(3.1±0.7)、(2.5 ±0.5)d,현저소우대조조적(2.5±1.1)、(4.6±0.8)、(3.7 ±0.8)d,차이균유통계학의의(P치균＜0.05).강화조절구감염솔현저저우대조조(5.9％비23.5％,P＜0.05),기타술후병발증발생솔급병사솔여대조조비교차이무통계학의의.결론 강화혈당공제가개선이선암합병당뇨병환자술후이도소저항,감경술후적염성반응,촉진환자회복,차불증가술후병발증적발생솔.
Objective To explore the correlation between blood glucose and postoperative recovery of pancreatic cancer patients with diabetes.Methods According to the level of glycemic control after operation,68 cases of pancreatic cancer patients with diabetes were divided into two groups,including 34 cases of intensive control group (blood glucose 4.4 ～ 6.1 mol/L),34 cases of control group (blood glucose 6.1 ～11.1 mol/L).Fasting blood glucose (FBG),fasting insulin (FINS) and C reaction protein (CRP) in all patients were detected at 1st,3rd and 7th day after operation,and the recovery condition,postoperative complications and other clinical data were compared and analyzed.Results FBG,FINS and CRP in intensive control group were (6.94 ± 0.94) mmol/L,(17.38 ± 7.37) mmol/L,(108.33 ± 37.25) mg/L,and in control group were (7.81 ± 1.36) mmol/L,(23.73 ± 8.25) mmol/L,(131.51 ± 42.34) mg/L at 3rd day after operation.There were significant difference in serum FBG,FINS and CRP level between the two groups at 3rd day after operation (P ＜ 0.05).Compared with control group,postoperative duration of fever [(1.4 ± 0.8) vs (2.5 ± 1.1) d],duration of antibiotics [(3.1 ± 0.7) vs (4.6 ± 0.8) d] and time of anal exhaust [(2.5 ±0.5) vs 93.7 ± 0.8)d] in intensive group were significantly reduced (P ＜ 0.05).The wound infection rate in intensive control group was significantly decreased (5.9％ vs 23.5％,P ＜0.05),the rate of mortality and other postoperative complications between the two groups was not statistically significant (P＞0.05).Conclusions Intensive glycemic control can contribute to improve insulin resistance,reduce inflammation reaction and improve the prognosis of postoperative pancreatic cancer patients with diabetes,and it does not increase the postoperative complication rate.
