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目的 探讨食管贲门癌合并糖尿病的围手术期处理。方法 回顾性总结13例食管贲门癌合并糖尿病病人的围手术期处理经验。术前、术中、术后均用普通胰岛素控制糖尿病,补糖以5％GS或5％GNS为主,按1u普通胰岛素:5g糖的比例补液,并按尿糖一个“+”追加普通胰岛素0.025u/kg/h的剂量,使尿糖控制在“±～++”,血糖略高于正常水平。结果 手术切口皆为甲级愈合,无1例发生糖尿病酮症酸中毒,非酮症高渗性昏迷或低血糖休克。结论 妥善的围手术期处理明显减少食管贲门癌合并糖尿病患者的术后并发症,胰岛素的合理应用是治疗成功的关键。
Objective To investigate the perioperative management of esophageal and cardiac cancer with diabetes. Methods We retrospectively summarized the perioperative management experience of 13 patients with esophageal and cardiac cancer complicated with diabetes. Preoperative, intraoperative and postoperative use of normal insulin control of diabetes, supplemented with 5% GS or 5% GNS, according to 1u ordinary insulin: 5g sugar ratio of rehydration, and according to a “+” urine supplement ordinary insulin At a dose of 0.025u/kg/h, urine glucose was controlled at “± ++”, and blood glucose was slightly higher than normal. Results All surgical incisions were Grade A. None of the patients had diabetic ketoacidosis, nonketotic hyperosmolar coma, or hypoglycemic shock. Conclusion Proper perioperative management significantly reduces the postoperative complications of esophageal and cardiac cancer patients with diabetes. The rational use of insulin is the key to successful treatment.