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在糖尿病外科病人,除代谢障碍外,还较常发生与糖尿病有关的危险因素。除了控制血糖以外,必须制定防治这些并发症的方案。糖尿病病人常伴冠状动脉疾病和心脏贮备力降低。再者,经常遇到肾功能损害。须仔细处理液体和电解质负荷。自主神经病使某些病人易受某些药物的影响,引起呼吸抑制和心肺停搏。由于大手术本身就是额外的应激,所有的糖尿病人(不论是胰岛素依赖性或非依赖性),都应予以通过静脉或皮下注射正规胰岛素的控制。在术中和术后即期,除非存有肾功能衰竭或葡萄糖肾阈升高外,用药剂量应根据尿糖控制的结果加以调整。在应激期采用静脉营养须另补充胰岛素。每6小时检查血糖和尿酮。凡尿酮阳性,应通知内科医生。若尿糖阴性,血糖值为150～200 mg/100 ml时,则
In diabetic surgical patients, in addition to metabolic disorders, but also more often occur with diabetes-related risk factors. In addition to controlling blood sugar, programs to combat these complications must be developed. Patients with diabetes are often associated with coronary artery disease and reduced heart reserve. Again, often encountered kidney damage. Liquid and electrolyte loads must be carefully handled. Autonomic neuropathy makes certain patients susceptible to certain medications, causing respiratory depression and cardiopulmonary arrest. Because major surgery is inherently stressful, all people with diabetes (whether insulin-dependent or independent) should be controlled by intravenous or subcutaneous injections of regular insulin. Intraoperative and postoperative immediately, unless there is renal failure or increased renal glucose threshold, the dosage should be based on the results of urine control to be adjusted. In the stress of intravenous nutrition to be supplemented with insulin. Check blood glucose and urinary ketone every 6 hours. Where urinary ketone positive, physicians should be informed. If the urine negative, blood glucose value of 150 ~ 200 mg / 100 ml, then