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目的研究肝移植围手术期糖尿病对患者的影响及防治措施。方法回顾性分析131例肝移植患者临床资料,观察患者围手术期糖尿病的发生及对术后并发症的影响,探讨移植术后新发糖尿病与原发疾病、术后免疫抑制药物等因素的关系。结果移植术后新发糖尿病发生率为19．3％(21／109),与糖尿病家族史和术后使用大剂量激素有关,与非糖尿病患者相比,围手术期糖尿病患者急性排斥反应、细菌感染、高血压等并发症的发生率显著升高(P<0．05),术前及术后早期(2周内)将血糖降至正常可减少感染的发生。结论围手术期出现糖尿病会增加肝移植患者术后并发症的发生率,应该有效控制血糖以减少感染并发症的发生,同时肝移植术后早期应避免使用大剂量激素。
Objective To study the effect of perioperative diabetes mellitus patients with liver transplantation and its prevention and treatment. Methods The clinical data of 131 patients with liver transplantation were retrospectively analyzed. The incidence of perioperative diabetes mellitus and postoperative complications were observed. The relationship between new-onset diabetes mellitus and post-transplant immunosuppressive drugs and other factors . Results The incidence of new-onset diabetes was 19.3% (21/109) after transplantation, which was related to the family history of diabetes and the use of high-dose hormones. Compared with non-diabetic patients, acute rejection in perioperative diabetic patients, The incidence of complications such as infection and hypertension was significantly increased (P <0.05). The reduction of blood glucose to normal before and after surgery (2 weeks) could reduce the incidence of infection. Conclusion Perioperative diabetes can increase the incidence of postoperative complications in patients undergoing liver transplantation. Blood glucose should be controlled to reduce the incidence of complications. In the meantime, high dose hormones should be avoided early after liver transplantation.