妇科疾病合并糖尿病56例的围手术期处理.docVIP

妇科疾病合并糖尿病56例的围手术期处理 【关键词】 酮症酸中毒 【摘要】 目的 探讨妇科疾病伴糖尿病患者围手术期处理方法。方法 回顾性分析了56例妇科疾病伴糖尿病患者的手术治疗，将治疗的重点放在对糖尿病的监测和控制上，术前饮食控制，早、中、晚餐前胰岛素皮下注射，术中监测血糖，术后禁食水期间，每日补充葡萄糖150g，并按糖∶胰岛素为4～5∶1的比例给予胰岛素治疗，以防止酮症酸中毒。结果 全组治愈56例，其中6例出现不同程度的念珠菌阴道炎。结论 对于妇科疾病伴糖尿病的患者，将血糖控制在5.6～11.0mmol/L ，尿糖控制在（±）时实施手术较为安全。另外应用有效的抗生素预防术后感染也是保证手术成功的重要因素之一。 【关键词】 糖尿病；酮症酸中毒；围手术期；妇科疾病 Perioperative management of gynecological diseases in 56 cases accompanied with diabetes mellitus YANG Xin-hua,SUN Hui-bing. Department of Gynecology,The Second Peoples Hospital of Changji,Changji 831100,China 【Abstract】 Objective To explore the optimal treatment on perioperative patients with gynecological diseases accompanied by diabetes mellitus.Methods Fiftysix patients with gynecological diseases accompanied by diabetes who underwent operative treatment were analyzed retrospectively.The focus of treatment was allocated on monitoring and control of diabetes,control of food and drink before operation,and subcutaneous injection of insulin at morning,noon,night.Monitoring of blood glucose should be made during operation.The supplementary glucose everyday should be 150 g during the period of postoperative procedure and insulin therapy should be adopted simultaneously in case of ketoacidosis developed in proportion of 4～5g glucose:1u insulin.Results 56 patients cured and 6 patients among them in various degress appeared candidal vaginitis.Conclusion For the patients with gynecological diseases accompanied by diabetes,operative therapy is relatively safe when the blood glucose is controlled in the range of 5.6 to 11.0 mol/L,and the urine glucose is (±).In addition,effective application of antibiotic to prevent postoperative infection is one of the important factors ensuring a successful operation. 【Key words】 diabetes mellitus;ketoacidosis;perioperation;gynecological diseases 妇科疾病患者合并糖尿病增加了处理难度，正确的围手术期处理能有效减少患者的并发症及降低死亡率。本文回顾性分析了我院1998年12月～2005年12月收治的糖尿病患者实施手术56例，现对其围手术期的合理处理方法探讨如下。 1 资料与方法 1.1 一般资料 本组56例，年龄35～76岁，平均51岁。其中子宫腺肌瘤30例，卵巢畸胎瘤