CAJ | 학술논문

目的：探讨非糖尿病性高血糖对腹腔镜结直肠癌根治术后并发症的影响。方法回顾性分析2009―2013年间南方医科大学附属南海医院实施的636例腹腔镜结直肠癌根治术患者的临床资料,排除糖尿病患者后,按住院期间血糖情况分为高血糖组(住院期间任意时点的血浆葡萄糖水平大于7.8 mmol/L,161例)和非高血糖组(309例)。结果与非高血糖组相比,高血糖组患者术中出血量显著增加[(186±80) ml比(158±74) ml,P=0.007],术后住院时间明显延长[(14.0±6.8) d比(11.2±5.5) d,P=0.013]。高血糖组和非高血糖组术后并发症发生率分别为24.8%(40/161)和16.5%(51/309),差异有统计学意义(P=0.030)﹔围手术期病死率分别为1.2%(2/161)和0.6%(2/309),差异无统计学意义(P=0.541)。Logistic多因素回归分析证实,高血糖是手术后并发症发生的独立危险因素(RR=2.425,95%CI：1.210~4.226,P=0.006)。结论非糖尿病性高血糖会增加腹腔镜结直肠癌根治术后并发症的发生风险,因此,围手术期应加强血糖监测和必要的降糖干预,无论患者是否有糖尿病史。
목적：탐토비당뇨병성고혈당대복강경결직장암근치술후병발증적영향。방법회고성분석2009―2013년간남방의과대학부속남해의원실시적636례복강경결직장암근치술환자적림상자료,배제당뇨병환자후,안주원기간혈당정황분위고혈당조(주원기간임의시점적혈장포도당수평대우7.8 mmol/L,161례)화비고혈당조(309례)。결과여비고혈당조상비,고혈당조환자술중출혈량현저증가[(186±80) ml비(158±74) ml,P=0.007],술후주원시간명현연장[(14.0±6.8) d비(11.2±5.5) d,P=0.013]。고혈당조화비고혈당조술후병발증발생솔분별위24.8%(40/161)화16.5%(51/309),차이유통계학의의(P=0.030)﹔위수술기병사솔분별위1.2%(2/161)화0.6%(2/309),차이무통계학의의(P=0.541)。Logistic다인소회귀분석증실,고혈당시수술후병발증발생적독립위험인소(RR=2.425,95%CI：1.210~4.226,P=0.006)。결론비당뇨병성고혈당회증가복강경결직장암근치술후병발증적발생풍험,인차,위수술기응가강혈당감측화필요적강당간예,무론환자시부유당뇨병사。
Objective To investigate the influence of non-diabetic hyperglycemia on postoperative complications following laparoscopic colorectal cancer resection. Methods Clinical data of 636 patients undergoing laparoscopic colorectal cancer resection in The Affiliated Nanhai Hospital of Southern Medical University between 2009 and 2013 were analyzed retrospectively. After excluding cases with diabetes mellitus, the patients were divided into the hyperglycemia group(blood glucose level> 7.8 mmol/L at any time during hospitalization period, n=161) and the non-hyperglycemia grou p (n=309). Results Compared to non-hyperglycemia group, hyperglycemia group had more intraoperative blood loss [(186±80) ml vs. (158±74) ml, P=0.007] and longer postoperative hospital stay [(14.0± 6.8) d vs. (11.2 ±5.5) d, P=0.013]. The overall rate of postoperative complication was 24.8% and 16.5% respectively (P=0.030), in the hyperglycemia and the non-hyperglycemia groups, and the mortality was 1.2% and 0.6% respectively(P=0.541). Multivariable analysis showed hyperglycemia was an independent risk factor of postoperative complication (RR=2.425, 95% CI:1.210-4.226, P=0.006). Conclusions Non-diabetic hyperglycemia may increase the risk of postoperative complications following laparoscopic colorectal cancer resection. Perioperative blood glucose monitoring should be performed, regardless of patients with or without diabetes.