论文部分内容阅读
目的:探讨胃癌合并糖尿病患者术后强化血糖控制的临床疗效及其对预后的影响。方法:根据不同血糖控制方法,将96例胃癌合并糖尿病术后患者分为强化血糖控制组50例(血糖控制在4.4-6.1mol/L)和对照组46例(血糖控制在6.1~11.1mol/L)。监测患者术后1、3、7天的空腹血糖(FBG)、空腹胰岛素定量(FINS)、及C反应蛋白(CRP)水平,并计算胰岛素抵抗指数(HOMA-IR),比较分析两组术后恢复情况及并发症发生情况。结果:术后1、3、7天,强化血糖控制组FBG、lnHOMA-IR及CRP水平均显著低于对照组,差异有统计学意义(P<0.05);术后1天两组间FINS水平差异无统计学意义(P>0.05),而术后3、7天,二者之间差异有统计学意义(P<0.05);强化血糖控制组术后发热时间、排气时间、抗生素使用时间与对照组相比明显缩短,差异有统计学意义(P>0.05);强化血糖控制组术后并发症的发生率2.0%,显著低于对照组13.0%,差异有统计学意义(P<0.05)。结论:强化血糖控制可改善胃癌合并糖尿病患者术后胰岛素抵抗,减轻术后的炎性反应,降低术后并发症,改善患者预后。
Objective: To investigate the clinical efficacy of intensive glycemic control in patients with gastric cancer complicated with diabetes mellitus and its effect on prognosis. Methods: According to different blood glucose control methods, 96 patients with gastric cancer complicated with diabetes were divided into intensive glycemic control group of 50 patients (blood glucose control 4.4-6.1mol / L) and control group of 46 patients (blood glucose control in 6.1 ~ 11.1mol / L). The fasting blood glucose (FBG), fasting insulin (FINS) and C-reactive protein (CRP) levels were measured at 1, 3 and 7 days after operation and the insulin resistance index (HOMA-IR) was calculated. Recovery and complications occurred. Results: The levels of FBG, lnHOMA-IR and CRP in intensive glycemic control group were significantly lower than those in control group on the 1st, 3rd, 7th day after operation (P <0.05). The levels of FINS (P> 0.05), but there was a significant difference between the two groups (P <0.05) at 3 and 7 days after operation. The duration of heating, deflation, antibiotic use time (P> 0.05). The incidence of postoperative complications in intensive glycemic control group was 2.0%, which was significantly lower than that in control group (13.0%), the difference was statistically significant (P <0.05 ). Conclusion: Intensive blood glucose control can improve postoperative insulin resistance, reduce postoperative inflammatory response, reduce postoperative complications and improve prognosis in patients with gastric cancer complicated with diabetes mellitus.