合并糖尿病的胸部手术患者154例治疗分析.docVIP

合并糖尿病的胸部手术患者15４例治疗分析 　　作者：左军涛　　作者单位：西安市长安区医院，陕西 西安 710100 　　【摘要】 目的：探讨合并糖尿病的胸部手术患者的外科治疗措施。方法：对我院心胸外科1990年至2003年治疗的154例合并有糖尿病的胸部手术患者作回顾性的分析。结果：154例患者中，择期手术128例，限期手术24例，术前空腹血糖均控制在6.2 mmol/L～8.5 mmol/L;急诊手术2例，术前空腹血糖8.0 mmol/L～13.5 mmol/L，术中血糖控制在8.0 mmol/L～8.5 mmol/L，术后血糖控制在7.5 mmol/L以下。术后并发症：切口感染7例，肺部感染5例，脓胸2例，泌尿系感染2例。无酮症酸中毒，无死亡病例。结论：合并糖尿病患者的胸部手术只要在围手术期严格控制血糖，作好必要的胃肠道及呼吸道准备，选择合理的手术时间完全可以达到理想的外科治疗效果。 　　【关键词】 糖尿病,胸部手术,围手术期,胰岛素 　　Analysis of Chest Surgery in 154 Cases Complicated with Diabetes　ZUO Juntao　Changan District Hospital of Xian，Xian, Shaanxi 710100,China 　　Abstract: Objective To explore the chest surgery complicated with diabetes mellitus. Methods From 1990 to 2003,154 patients with diabetes mellitus undergoing chest surgery in The Second Hospital of Xian Jiaotong University were analyzed retrospectively. Results Of all 154 cases ,128 cases were subjected elective operations,24 cases underwent time limited operations.The peoperative fasting bloodglucose was controlled within 6.2 mmol/L～8.5 mmol/L;The remaining 2 cases received emergency operations.The peoperative fasting bloodglucose was controlled within 8.0 mmol/L～13.5 mmol/L.The operating fasting bloodglucosa was controlled within 8.0 mmol/L～8.5 mmol/L.The pastoperative fasting bloodglucose was controlled under 7.5 mmol/L.The morbidity of postoperative complication:incision infection in 7 cases,pneumonia in 5 cases,epyema in 2 cases,uninary tract infection in 2 cases.There was no postoperative diabetic ketoacidosis and operative death. Conclusion If the patients bloodglucose concentration perioperatively could be well controlled,the intestinal tract and breathing tract were well prepared,and the opportunity of operation selected reasonably,the effect of surgical treatment on the patients of chest surgery complicated with diabetes mellitus would be very gratified. 　　Key words: Diabetes mellitus; Chest surgery; During perioperation; Insulin 　　糖尿病是一组以慢性高血糖为主要表现的全身性内分泌代谢性疾病。据Jacober