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目的对恶性肿瘤相关糖尿病的临床治疗方法进行探讨。方法选择本院肿瘤科在2009年3月至2010年9月间收治的恶性肿瘤合并糖尿病的患者35例,全部患者均经病理学确诊患有恶性肿瘤,根据WHO糖尿病相关诊断标准进行糖尿病的诊断,肿瘤诊断前确诊糖尿病患者21例,化疗前确诊糖尿病患者14例,对其肿瘤及糖尿病的治疗方法进行分析。结果 32例患者完成预定化疗周期,2例患者在化疗中反复出现中性粒细胞下降、Ⅲ度骨髓抑制,骨穿刺提示患者造血干细胞功能低下,因而化疗中止。1例晚期肝癌患者在化疗开始时血糖出现显著升高,尿酮体呈阳性,中止化疗,协同内分泌科进行对症处理,血糖控制不理想,最终停止化疗。全组患者无酮症酸中毒、反应性低血糖、非酮症糖尿病昏迷以及感染等症状。结论对于恶性肿瘤合并糖尿病患者,只要对其血糖进行理想的控制,就能够顺利完成预定的化疗。
Objective To investigate the clinical treatment of malignant tumor-associated diabetes. Methods Totally 35 patients with malignant neoplasm with diabetes mellitus admitted from March 2009 to September 2010 in our hospital were enrolled. All patients were pathologically diagnosed with malignant neoplasm. According to WHO diagnostic criteria for diabetes, the diagnosis of diabetes mellitus , 21 cases of diagnosed diabetes before tumor diagnosis, 14 cases of diagnosed diabetes before chemotherapy, and analyzed the treatment of tumor and diabetes. Results 32 patients completed the scheduled chemotherapy cycle, 2 patients recurred neutrophils in chemotherapy, Ⅲ degree myelosuppression, bone puncture prompted patients with hematopoietic stem cell dysfunction, chemotherapy and thus termination. One patient with advanced hepatocellular carcinoma showed a marked increase in blood glucose, urine ketone body was positive at the beginning of chemotherapy, chemotherapy was discontinued, synergistic with endocrine department for symptomatic treatment, blood glucose control was not satisfactory, and finally stopped chemotherapy. All patients without ketoacidosis, reactive hypoglycemia, nonketotic diabetic coma and infection and other symptoms. Conclusion For malignant tumor patients with diabetes, as long as the ideal blood glucose control, we can successfully complete the scheduled chemotherapy.