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目的探讨老年妇科恶性肿瘤合并糖尿病患者围手术期的血糖控制方案。方法选取2012年7月至2013年7月收治的需进行手术的老年恶性肿瘤合并糖尿病患者60例作为研究对象,随机分为观察组和对照组,每组30例。对照组患者采用传统的术前、术中和术后血糖管理,观察组患者采用新型的血糖管理方案。比较两组患者手术时间、术后地塞米松使用时间及用量、胰岛素用量,观察患者血糖控制情况、控制血糖所需时间、控制良好患者的平均血糖水平,低血糖发生次数等。结果两组血糖手术时间、地塞米松使用时间、胰岛素用量、血糖控制良好患者平均血糖浓度、发生低血糖及严重低血糖例数、血糖波动等差异无统计学意义(P>0.05),观察组患者控制良好患者及所用时间均优于对照组,对照组患者血糖>20mmol/L及追加胰岛素治疗的患者高于观察组,差异有统计学意义(P<0.05)。结论老年妇科恶性肿瘤合并糖尿病患者在围手术期采用新型的血糖管理方案能够提高血糖控制水平,血糖控制速度较快,血糖波动幅度小,值得临床推广。
Objective To investigate the perioperative glycemic control of elderly patients with gynecologic malignant tumor complicated with diabetes mellitus. Methods Sixty elderly patients with malignant neoplasm associated with diabetes undergoing surgery from July 2012 to July 2013 were selected as study subjects and randomly divided into observation group and control group with 30 cases in each group. Patients in the control group received traditional preoperative, intraoperative and postoperative glucose management, and patients in the observation group received a novel glucose management program. The operation time, the time and dosage of dexamethasone, the amount of insulin, the control of blood glucose, the time needed to control blood sugar, the average blood glucose level and the number of hypoglycemia in patients with good control were compared between the two groups. Results There were no significant differences in the duration of blood glucose surgery, the duration of dexamethasone use, the amount of insulin, the average blood glucose level, the incidence of hypoglycemia and severe hypoglycemia, blood glucose fluctuation in patients with good glycemic control (P> 0.05) Patients with well-controlled patients and the use of time are better than the control group, the control group of patients with blood glucose> 20mmol / L and additional insulin treatment was higher in the observation group, the difference was statistically significant (P <0.05). Conclusion The elderly patients with gynecological malignant tumor with diabetes in the perioperative period using a new blood glucose management program can increase blood sugar control, blood sugar control faster, small fluctuations in blood glucose, worthy of clinical promotion.