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目的探讨糖尿病并发结石性胆囊炎急性发作的手术时机。方法回顾分析36例糖尿病并发急性结石性胆囊炎发作患者的临床资料,33例有明确的糖尿病病史,3例入院后确诊,均行开腹胆囊切除术。结果36例患者术后并发伤口感染4例,并发急性左心衰1例,无死亡,均未发生酮症酸中毒,10～15d出院。结论糖尿病并发结石性胆囊炎急性发作时,炎症和高血糖互为因果,保守治疗不易控制炎症的发展和高血糖,而及时切除病灶,则有利于血糖的控制和病情的恢复。
Objective To investigate the timing of surgery for the acute episode of diabetes complicated with stone cholecystitis. Methods The clinical data of 36 patients with diabetes mellitus and acute calculous cholecystitis were retrospectively analyzed. 33 patients had a definite history of diabetes mellitus and 3 patients were diagnosed after admission. All patients underwent open cholecystectomy. Results Thirty-six patients were complicated with wound infection in 4 cases, complicated by acute left heart failure in 1 case, without death, all without ketoacidosis and discharged from 10 to 15 days. Conclusions In acute episodes of diabetes mellitus complicated with cholecystitis, inflammation and hyperglycemia are the causal factors. Conservative treatment is not easy to control the development of inflammation and hyperglycemia. However, timely removal of the lesion is beneficial to the control of blood glucose and the recovery of the disease.