胰岛素强化治疗对门脉高压脾切除术后并发症的影响

目的：观察胰岛素强化治疗对预防门脉高压脾切除术后并发症的疗效。方法：对115例门脉高压行脾切除患者随机分为观察组（n=58）和对照组（n=57）。对照组给予胰岛素强化治疗．血糖控制在4．4mmol／L～6．1mmol／L；对照组给予常规胰岛素治疗，血糖控制在10．0mmol／L-11．1mmol／L。观察两组患者患者术后并发症发生情况。结果：观察组中术后出血发生率和肺部感染发生率明显低于对照组，有统计学意义（P〈0．05）。而两组腹腔感染、门静脉血栓形成及胸腔积液发生率差异无统计学意义（P〉0．05）。观察组发生低血糖3例。对照组发生1例。结论：门脉高压脾切除术后胰岛素强化治疗能减少术后出血及肺部感染发生率，提高手术疗效。

Effects of intensive insulin therapy on postoperative complications of splenectomy in patients with portal hypertension

Objective To investigate the curative effects of intensive insulin therapy on preventing the postoperative complications of splenectomy in patients with portal hypertension. Methods 115 patients with portal hypertension after splenectomy were randomly assigned to intensive insulin therapy group（58 cases）and control group （57 cases）. The intensive insulin therapy group was given intensive insulin therapy, and their blood glucose level was controlled between 4. 4 - 6. mmol/L. The control group was given normal insulin therapy, and the blood glucose level was controlled between 10. 0~ 11. 1mmol/L. The postoperative complications were compared between two groups. Results The ratios of postoperative hemorrhage or lung infection in the control group were higher than those in the intensive insulin therapy group （P〈0. 05）. But the ratios of peritoneal cavity infection, portal vein thrombosis or pleural effusion had no significant difference between the two groups （P〉0. 05）. Three patients had hypoglycemia in the intensive insulin therapy group,one in the control group. Conclusions Intensive insulin therapy can lessen the ratios of postoperative hemorrhage or lung infection after splenectomy in patients with portal hypertension and raise the operation effects.