糖尿病人紧急手术时的诊治体会

为探讨急诊外科疾病合并糖尿病的诊治，对２４例患者进行临床观察。其临床特点：发病急，病程短，症状和体征较典型。治疗：降糖采用正规胰岛素，血糖≥１３．９ｍｍｏｌ／Ｌ，每小时静脉或皮内注射５～１０Ｕ胰岛素，酮症酸中毒者初量２０Ｕ胰岛素；血糖＜１３．９ｍｍｏｌ／Ｌ，每小时５Ｕ胰岛素，直至１０ｍｍｏｌ／Ｌ，并可补充葡萄糖，按比例加胰岛素（５ｇ糖１Ｕ胰岛素）；术中、术后维持术前糖和胰岛素比例。均行手术治疗。结果：降糖迅速、安全，血糖控制在８～１０ｍｍｏｌ／Ｌ，波动范围不大，手术无严重并发症，均痊愈出院

Emergency surgery for patients complicated with diabetes

Investigation on 24 patients with surgery disease complicated diabetes showed that they had the clinical characteristics of sudden attack, shortage of disease course, and tipical of symptom and sign. Therapy: normal insulin was given to decrease blood sugar, if blood sugar≥13.9mmol/L, then the patients were given intravenous or intradermic injection insulin 5～10μ per hour, the patients with ketoacidosis were early given insulin 20μ; if blood sugar <13.9mmol/L, given insulin 5μ per hour, till 10mmol/L, moreover, the glucose could also be supplemented in the proportion of insulin ( glucose 5g plus insulin 20μ); this proportion must be sustained intra and post operation. All the surgery turned out to be immediately decreased blood glucose, control blood glucose 8～10mmol/L, small-range fluctuation and noncomplication. All of them were cured and out of hospital healthily.