肺结核合并2型糖尿病患者行电视胸腔镜手术治疗的临床分析

目的：探讨电视胸腔镜手术治疗肺结核合并2型糖尿病患者的临床效果及围手术期处理措施。方法：对我院2006年1月-2012年12月期间行电视胸腔镜外科手术治疗肺结核合并2型糖尿病64例患者的临床资料进行分析总结,统计围手术期血糖水平、术后并发症、术后半年内结核活动复发情况,记录围手术期控制血糖、营养支持、抗结核、抗感染等措施。结果：所有患者无围手术期死亡者,经充分抗结核、抗感染、营养支持治疗,将围手术期血糖控制到6.0-10.0mmol/L之间后,未增加患者手术后感染及结核活动复发率,且未发生严重心血管意外、酮症酸中毒、高渗昏迷、支气管残端瘘等并发症。结论：在严格掌握手术适应证,完善围手术期治疗手段后,电视胸腔镜手术治疗肺结核合并2型糖尿病患者是安全有效的。

The Clinical Investigation of VATS Treatment of Tuberculosis Associated with Type 2 Diabetes Mellitus

Objective：To study the perioperative management and the results of VATS treatment of tuberculosis associated with type 2diabetes mellitus.Methods：The clinical data were analysed retrospectively from 64 patients with tuberculosis associated with type 2diabetes mellitus who were treated by VATS between January 2006 and December2012.To collect the date of perioperative blood glucose levels,the postoperative complications and postoperative relapse tuberculosis activity half a year,and to record the measure of blood glucose control,nutritional support,anti-tuberculosis and anti-infection during perioperation.Results：There were no preoperative death.After adequate treation of anti-tuberculosis,anti-infecting nutritional support and preoperative glycemic control between 6.0~10.0mmol/L,the incidence of postoperative infection and recurrent tuberculosis infections didn＇t increase and the complications including serious cardiovascular accident,diabetic ketoacidosis,hyperosmolar nonketonic diabetic coma,bronchial stump fistula didn＇t occur.Conclusion：VATS treatment of tuberculosis associated with type 2diabetes mellitus is safe and effective when holding the operative indication strictly and consummating perioperative management.