57例糖尿病肿瘤患者围手术期处理体会

目的：研究糖尿病肿瘤患者围手术期持续静脉注射胰岛素（微量泵）的可行性,评价血糖稳定对促进患者恢复的影响。方法：在就诊于我科患者中连续选取57例糖尿病患者使用微量泵进行胰岛素注射治疗,使围手术期内患者血糖维持在理想的范围。结果：使用微量泵持续皮下胰岛素注射治疗之后,患者血糖控制理想,24小时之内维持于正常水平者占71.93%,术后无患者出现酮症酸中毒或高渗性昏迷,切口愈合明显好于一般糖尿病患者（P〈0.05）。4例发生术后感染,均在一周内治愈,术后感染的发生率为7.02%。结论：持续静脉输注胰岛素可快速将围手术期患者血糖控制在满意水平,降低术后感染率,促进患者恢复,减少手术并发症。

Experience of treatment on 57 diabetic tumor patients during the perioperative period

Objective:To study the feasibility of continuous insulin intravenous infusion and to evaluate its effect of blood sugar stability on the prognosis of diabetic tumor patients during the perioperative period.Methods:Fifty-seven patients performed operation were enrolled into the study and received continuous insulin intravenous infusion.Their blood sugar levels were expected to be ideally controlled by using insulin pump during the perioperative period.Results:Patients got the ideal blood sugar level after receiving the continuous insulin intravenous infusion by using insulin pump.71.93% patients returned to the normal level within 24h.No patient suffered hyperosmolar nonketotic diabetic coma or ketoacidosis during perioprative period,also obtained a better wound healing result compared with those patients without continuous insulin intravenous infusion(P<0.05).Infections occurred only in 4 cases and all of thenm were cured within a week;the postoperative infection rate was 7.02%(4/57).Conclusion:Cont inuous insulin intravenous infusion by pump can be used to control blood sugar level in patients during perioperative period,the blood sugar in the perioperative period can be controlled to the satisfying level in a short time,and the operative complications could be reduced in diabetic cancer patients.