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目的分析无症状胆囊结石发病率和糖尿病之间的关系,讨论糖尿病合并无症状胆囊结石时是否应该手术治疗以及糖尿病病人胆道手术的围手术期处理。方法回顾601例胆囊结石,46例合并糖尿病,男性17例,女性29例,开腹胆囊切除10、腹腔镜胆囊切除26例,10例内科治疗,对46例合并糖尿病的胆囊结石病人进行相关性分析。结果术后切口感染2例,肺部感染2例,泌尿系统感染1例,无手术死亡病例,2例非手术病人死于感染性休克。结论无症状胆囊结石合并糖尿病时,即使不做预防性胆囊切除,也应该在一旦出现症状时尽早手术治疗。围手术期应严密监测血糖,根据病情持续静滴含胰岛素的葡萄糖液体,并注意维持好代谢平衡。
Objective To analyze the relationship between the incidence of asymptomatic gallstones and diabetes mellitus, and to discuss whether perioperative management of diabetes mellitus with asymptomatic gallbladder stones and surgical management of biliary tract surgery in diabetic patients should be carried out. Methods Sixty-one patients with gallstone and 46 patients with diabetes mellitus were retrospectively reviewed. Sixty-six patients with diabetes mellitus, 17 males, 29 females, 10 patients undergoing open cholecystectomy, 26 patients undergoing laparoscopic cholecystectomy and 10 patients undergoing medical treatment were enrolled. analysis. Results Postoperative incision infection in 2 cases, pulmonary infection in 2 cases, urinary tract infection in 1 case, no surgical deaths, 2 cases of non-surgical patients died of septic shock. Conclusion Asymptomatic gallstones with diabetes mellitus, even without preventive cholecystectomy, should be treated as soon as possible in the presence of symptoms. Perioperative monitoring of blood glucose should be closely, according to the disease continued intravenous infusion of insulin-containing glucose fluid, and pay attention to maintaining a good metabolic balance.