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目的探讨合并高血糖的肝癌患者行肝切除手术的围手术期处理措施。方法对98例合并高血糖的肝癌行肝切除患者的临床资料进行回顾性分析。结果患者术前空腹血糖均控制在6.1～11.1μmol/L,尿酮体(-);术中血糖控制在6.8～11.2μmol/L;术后使用胰岛素控制血糖。98例均顺利施行了手术。手术恢复良好,仅发生切口感染7例(7.14%),肺部感染3例(3.06%),泌尿系感染3例(3.06%),腹腔脓肿1例(1.02%),肺部感染病例中1例(1.02%)合并酮症酸中毒。结论肝癌患者肝功异常可能诱发高血糖或加重原有糖尿病。对合并高血糖的患者,围手术期严格控制血糖,加强营养支持,积极处理感染、酮症酸中毒等并发症,是外科手术治疗成功的关键。
Objective To investigate the perioperative management of liver resection in patients with hepatocellular carcinoma (HCC) complicated with hyperglycemia. Methods The clinical data of 98 patients with hepatocellular carcinoma with hyperglycemia underwent hepatectomy were analyzed retrospectively. Results The preoperative fasting blood glucose was controlled at 6.1 ~ 11.1μmol / L, urinary ketone body (-); intraoperative blood glucose control at 6.8 ~ 11.2μmol / L; postoperative insulin was used to control blood sugar. 98 cases were successfully performed the operation. Surgical recovery was good. Only 7 cases (7.14%) had incisional infection, 3 cases (3.06%) had pulmonary infection, 3 cases (3.06%) had urinary tract infection, 1 case (1.02%) had abdominal abscess, 1 Cases (1.02%) with ketoacidosis. Conclusion Hepatic cancer patients with abnormal liver function may induce hyperglycemia or aggravate the original diabetes. For patients with hyperglycemia, perioperative strict control of blood glucose, nutritional support, and actively handle the infection, ketoacidosis and other complications, is the key to the success of surgical treatment.