老年糖尿病急腹症的围手术期处理

目的探索老年急腹症患者合并糖尿病时围手术期处理的安全措施。方法回顾性分析46例老年急腹症合并糖尿病患者围手术期处理的临床经验。结果全组无死亡病例，术中血糖控制在8．1～16mmol／L，术后血糖控制在6．1～8．2mmol／L。发生切口感染5例，切口哆开2例，肺部感染2例，尿路感染4例，水、电解质紊乱4例。结论血糖的有效控制，简洁有效的术式选择，重要脏器功能及内环境稳定的维持，合理抗生素的应用，是降低急诊手术风险、减少术后并发症的关键。

Perioperative Management of Acute Abdomen in Aged Patients with Diabetes Mellitus

Objective To explore a safe technique of perioperative management of acute abdomen combined with diabetics mellitus （T2DM） in aged patients. Methods A retrospective analysis was made in 46 cases suffered from acute abdomen combined with T2DM in aged patients. Results The blood sugar was between 8.1- 16mmol/L at operative phase and between 6.1-8.2mmol/L at postoperative phase by perioperative care. After operation,complications occurred as follows： wound sepsis（5 cases）, wound dehiscence （2 cases）, postoperative pneumonia（2 cases）, urinary tract infection（4 cases）, fluid and electrolyte imbalance（4 cases）. The above mentioned passed perioperative period uneventfully after treatment. Conclusion It is very important to decrease dangerous of emergency surgery and complications after operation by controlling blood sugar level effectively,choosing simple surgery,maintaining the stabilization of inner environment and using antibiotics properly.