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目的:探讨食管癌及贲门癌伴糖尿病患者围术期治疗的最佳方式。 方法:回顾性分析了 89例食管癌及贲门癌伴糖尿病患者的外科治疗 ,将治疗的重点放在对糖尿病监测和控制上。术前 3d停用口服降糖药 ,改为早、中、晚餐前胰岛素皮下注射 ,术中监测血糖 ,术后禁食水期间 ,每日补充的葡萄糖量不低于 12 5～ 15 0 g,并按糖∶胰岛素为 4～ 5∶ 1的比例给予胰岛素治疗 ,以防发生酮症酸中毒。 结果 :全组治愈 87例 ,死亡 2例。 结论:对于食管癌及贲门癌伴糖尿病患者 ,将血糖控制在 6～ 9mm ol/L,尿糖控制在 (± )时实施手术较为安全。另外应用有效的抗生素预防术后感染也是保证手术成功的重要因素之一。
Objective: To explore the best way of perioperative treatment of patients with esophageal and cardiac cancer with diabetes mellitus. Methods: Surgical treatment of 89 patients with esophageal and cardiac cancer with diabetes mellitus was retrospectively analyzed, and the treatment was focused on the monitoring and control of diabetes mellitus. Preoperative 3d stop taking oral hypoglycemic agents, replaced by insulin in early, middle and evening subcutaneous injection, intraoperative monitoring of blood glucose, postoperative fasting water, the daily amount of glucose replacement of not less than 12 5 ~ 15 0 g, And according to sugar: insulin ratio of 4 to 5: 1 to give insulin therapy to prevent ketoacidosis. Results: 87 cases were cured and 2 died. Conclusion: For patients with esophageal and cardiac cancer with diabetes mellitus, the control of blood glucose in 6 ~ 9mm ol / L, urine control in (±) when the operation is more safe. In addition the use of effective antibiotics to prevent postoperative infection is also an important factor to ensure the success of surgery.