糖尿病对胃癌患者术后短期结局的影响

目的探讨糖尿病对胃癌患者术后短期结局的影响。方法选择2006年1月至2008年6月在青岛大学医学院附属医院行手术治疗的639例胃癌患者,其中糖尿病患者82例(糖尿病组),非糖尿病患者557例(非糖尿病组)。分析并比较两组患者的术式、术后恢复情况、术后并发症发生率、病死率以及住院时间、住院费用等。结果糖尿病组患者肥胖/超重的发生率显著高于非糖尿病组(47.6%与26.9%,P=0.000),且前者的体质量指数显著高于后者(P=0.000)。糖尿病组患者手术根治率显著低于非糖尿病组(P=0.041),但前者的淋巴结清扫数目显著少于后者(P=0.045)。两组患者的术式、手术时间及术中出血量无统计学意义(P值分别为0.217、0.308和0.714)。两组患者术后并发症发生率比较,差异有统计学意义(23.2%与14.2%,P=0.035);其中糖尿病组患者胃排空障碍及切口感染的发生率显著高于非糖尿病组(P值分别为0.005和0.008)。糖尿病组患者的病死率显著高于非糖尿病组(P=0.000)。糖尿病组患者总住院时间显著长于非糖尿病组(P=0.033),且前者住院费用显著高于后者(P=0.026)。结论糖尿病影响了胃癌患者的手术治疗及术后短期结局。

The Relation of Diabetes Mellitus with Short-term Outcomes in Patients with Gastric Cancer

Objective To explore the relation between diabetes mellitus(DM)and short-term surgical outcomes in patients with gastric carcinoma.Methods A total of 639 gastric cancer patients have underwent gastrectomy at the affiliated hospital of qingdao university medical college during Junuary 2006 and May 2008.Among the patients,82 were complicated by DM(DM group),others were not(non-DM droup).The Clinical data including surgical opreration,postoperative recovery,postoperative complications,mortality,length of hospital stay hospitalization cost and etc were analyzed between the two groups.Results Obesity/over weight was more common in the DM-group than in the non-DM-group(47.6% vs 26.9%,P=0.000),and the former patients had higher mean BMI values(P=0.000).Less patients underwent radical operations in the DM-group(P=0.041),and less lymph nodes were dissected among these patients(P=0.045).There was no significant differeance between the two groups in terms of surgical modus,duration of the operation and blood lose(P=0.217,0.308,0.714).Patients with DM experienced more postoperative complications than the non-DM group did(23.2% vs 14.2%,P=0.035),espacially DM-group has a significantly higher incidence of delayed gastric empting and incision infection(P=0.005,0.008),and a higher mortality(P=0.000).Then the DM-group had a longer hospital stay and more hospitalization cost(P=0.033,0.026).Conclusion DM deteriorated the surgical treatment and postoperative recovery of the patients with gastric cancer.