急性脓胸并发1型糖尿病外科治疗及围术期处理

目的探讨急性脓胸并发1型糖尿病患者的外科治疗和围术期处理。方法对2001年2月～2007年2月我科17例急性脓胸合并1型糖尿病围术期处理的回顾性分析。结果本组15例在电视胸腔镜或辅助小切口下行脓胸清除引流、纤维板剥脱术，2例常规开胸行胸膜肺叶切除术。围术期密切控制血糖，术后1例出现低血糖症状，2例出现呼吸窘迫，经综合性治疗后治愈。结论1型糖尿病患者手术的耐受性下降，危险性增加，重视急性脓胸合并1型糖尿病患者围术期处理，减少并发症十分重要；急性脓胸的外科治疗效果明显。

The Surgical Operation and Perioperative Treatment to Patients with Acute Pyothorax and Type 1 Diabetes

Objective To investigate the operation and perioperative treatment of patients with acute pyothorax complicating type 1 diabetes. Methods Clinical data of 17 cases with acute pyothorax complicating type Ⅰ diabetes was analyzed restrospectively, which were admitted from Feb 2001 to Feb 2007. Results 15 patients received thoracoplasty or video-assisted thoracoseopic surgery （VATS） ,and 2 patients received conventional pleuropneumonectomy. Blood glucose was controlled perioperatively. 1 patient showed symptom of hypoglycemia and 2 patients appeared with acute respiratory distress syndrome （ARDS） ,and they were cured by combined therapy. Conclusion With decrease of tolerance for operation, it is danger for patients complicating type Ⅰ diabetes to receive operation. It was very important to emphasize the perioperative treatment of type 1 diabetic patient for decreasing complication ; the effect of surgical operation was significant in acute pyothorax.