胆道疾病合并糖尿病的外科治疗(附54例分析)

目的 观察胆道疾病合并糖尿病的外科治疗效果。方法 对1990～2000年经外科治疗的54例胆道疾病合并糖尿病病人进行回顾性分析。结果 7例因急症手术而未能获得术前血糖水平，其余47例均择期手术，术后并发胆汁漏7例，切口感染4例，胆道出血2例，应激性溃疡3例，腹腔脓肿3例，肺内感染4例，下肢静脉血栓形成1例，2例并发多器官功能衰竭死亡，其余均经对症处理治愈。术后平均住院25d痊愈出院。结论 糖尿病高血糖是术后并发症发生的主要形成因素.围手术期严格控制血糖．是降低并发症发生率和死亡率的关键。

SURGICAL TREATMENT OF BILIARY TRACT DISEASE COMPLICATED WITH DIABETES (WITH 54 CASES)

Objective To observe the curative effects of surgical treatment on biliary tract disease complicated with diabetes.Methods Retrospective analyses of the surgical treatment of 56 cases of biliary tract disease from 1990 to 2000 were made in this literature.Results 7 cases failed to have their blood sugar measured because of their emergency treatments.All the other cases underwent selective surgical treatments.The complications were as follows:postoperative bile leakage in 7 cases;incision infection in 4 cases;biliary tract hemorrhage in 2 cases,stress ulcer in 3 cases;abdominal abscess in 3 cases;intrapulmonary infection in 4 cases;phlebothrombosis of legs in 1 case and functional failure of organs in 2 cases.Expectant treatments were made in the remaining cases.The average hospitalization time was 25 days.Conclusion Hyperglycemia is the leading cause of the postoperative complications.The strict control of blood sugar in the perioperative period is the key to the reduction of the incidence of complications and the deat rate.