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目的探讨结直肠癌合并糖尿病患者的围手术期治疗方法。方法回顾性分析32例结直肠癌合并糖尿病患者的临床资料。结果32例患者均行手术治疗,其中根治性手术30例、结肠造瘘手术2例。术前空腹血糖控制在6.0~8.0 mmol/L,餐后血糖≤11.1 mmol/L,术后血糖维持在6.0~10.0 mmol/L。术后并发肺部感染4例,吻合口瘘1例,切口裂开2例,切口液化感染3例,心功能衰竭2例,结肠残端糜烂出血1例,其中2例切口裂开、1例心功能衰竭均合并肺部感染,所有病例均顺利度过围手术期。结论合理使用胰岛素,严格监测、控制血糖,完善妥当地处理结直肠癌合并糖尿病患者,能够安全度过围手术期。
Objective To investigate the perioperative management of colorectal cancer with diabetes mellitus. Methods The clinical data of 32 patients with colorectal cancer complicated with diabetes mellitus were retrospectively analyzed. Results 32 patients underwent surgical treatment, including radical surgery in 30 cases, colostomy in 2 cases. Preoperative fasting blood glucose control in 6.0 ~ 8.0 mmol / L, postprandial blood glucose ≤ 11.1 mmol / L, postoperative blood glucose remained at 6.0 ~ 10.0 mmol / L. Postoperative pulmonary infection in 4 cases, anastomotic fistula in 1 case, incision in 2 cases, incision liquefaction in 3 cases, heart failure in 2 cases, colon stump erosion bleeding in 1 case, 2 cases incision open, 1 case Heart failure with pulmonary infection, all cases were successfully perioperative period. Conclusion The rational use of insulin, strict monitoring and control of blood glucose, improve the proper treatment of colorectal cancer with diabetes, can safely perioperative period.