原发性肝癌合并2型糖尿病患者围手术期不同胰岛素控制方式的疗效评价

• 作 者: 努尔古丽·阿不都热西提 韩峰
• 机 构: 新疆医科大学附属肿瘤医院急诊综合医疗科,
• 出 处: 肿瘤基础与临床
• 发表日期: 2013年05期
• 关键词: 原发性肝癌 2型糖尿病 胰岛素泵 围手术期

目的总结肝癌合并2型糖尿病围手术期处理的经验,提出该类患者使用胰岛素泵强化血糖控制的围手术期处理体会。方法 37例原发性肝癌合并2型糖尿病患者随机分为胰岛素泵组和常规胰岛素组,比较2组患者的血糖水平变化及术后伤口愈合情况。结果 2组患者术前、术中及术后禁食期血糖水平比较差异均有统计学意义(P均<0.05);2组患者进食恢复后血糖水平比较差异无统计学意义(P>0.05)。2组患者血糖达标时间、平均胰岛素用量、低血糖发生率及切口延期愈合率比较差异均有统计学意义(P均<0.05)。结论肝癌合并2型糖尿病患者围手术期血糖控制至关重要,严密监测血糖、尿糖水平,规范围手术期胰岛素的强化治疗是预防术后并发症的关键。

Objective To summarize the experience of perioperative management of type 2 diabetes mellitus patients with hepatocellular carcinoma and to propose the perioperative management experience of these patients using insulin pump to enhance glycemic control. Methods 37 patients with primary hepatocellular carcinoma and type 2 diabetes mellitus were randomly divided into insulin pump group and conventional insulin group. The changes of blood glucose level and postoperative wound healing were compared between the two groups. Results There were significant differences in blood glucose levels before, during and after fasting between the two groups (all P <0.05). There was no significant difference in blood glucose level between the two groups (P> 0.05) . There were significant differences in the standard of glycemic control, average insulin dosage, the incidence of hypoglycemia and delayed incision healing between the two groups (all P <0.05). Conclusion Perioperative glycemic control in patients with hepatocellular carcinoma complicated with type 2 diabetes is very important. Monitoring blood sugar and urine sugar level closely is the key to preventing postoperative complications.