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目的探讨入院前无糖尿病史的消化道肿瘤患者围手术期血糖水平及意义。方法选取消化道肿瘤限期手术患者981例,包括食道癌组204例、胃癌组346例、结直肠癌组431例;比较3组患者的性别、年龄,术前丙氨酸氨基转移梅(ALT)、血肌酐(CRE)、血白蛋白(ALB)水平,以及术前及术后第1天空腹血糖水平,计量资料以(xˉ±s)表示,采用独立样本t检验;计数资料组间采用χ2检验,P<0.05为差异有统计学意义。结果 3组患者性别、年龄,术前ALT、CRE、ALB比较差异无统计学意义(P均>0.05)。981例患者术前空腹血糖(5.44±1.11)mmol/L,术后第1天(7.87±2.17)mmol/L,差异有统计学意义(P<0.01)。食道癌组术后第1天空腹血糖高于胃癌和结直肠癌组,差异有统计学意义(P<0.01),胃癌组与结直肠癌组间术后第1天空腹血糖比较,差异无统计学意义(P>0.05)。结论消化道肿瘤患者术后第1天空腹血糖较术前明显升高,不同手术部位患者术后血糖升高幅度有所不同。建议对消化道肿瘤手术患者检测术后第1天空腹血糖,以尽早发现术后高血糖。
Objective To investigate the perioperative blood glucose level and its significance in patients with gastrointestinal cancer before admission without diabetes mellitus. Methods A total of 981 patients undergoing gastrointestinal cancer surgery were included, including 204 cases of esophageal cancer, 346 cases of gastric cancer and 431 cases of colorectal cancer. The gender, age, preoperative ALT, , Serum creatinine (CRE) and serum albumin (ALB), as well as the fasting blood glucose level before and after the first day. The measurement data were expressed as (xˉ ± s), and the independent sample t test was used. Test, P <0.05 for the difference was statistically significant. Results There were no significant differences in sex, age, preoperative ALT, CRE and ALB between the three groups (all P> 0.05). The fasting blood glucose (5.44 ± 1.11 mmol / L) and the first day after operation (7.87 ± 2.17 mmol / L) in 981 patients were significantly different (P <0.01). Fasting plasma glucose was higher on day 1 postoperative in esophageal cancer patients than in gastric cancer and colorectal cancer patients (P <0.01). There was no statistical difference in fasting blood glucose between the first day and the postoperative day in gastric cancer patients and colorectal cancer patients Significance (P> 0.05). Conclusions The fasting blood glucose in patients with gastrointestinal cancer on the first postoperative day was significantly higher than that before the operation, and the postoperative increase in blood glucose was different in patients with different surgical sites. The proposed fasting blood glucose in patients with gastrointestinal cancer surgery on the first postoperative day to early detection of postoperative hyperglycemia.