乳腺癌合并糖尿病患者的围手术期血糖监控  

Monitoring the blood glucose of patients with mammary cancer complicating diabetic during the perioperative period

作　　者：郑婉婷[1] 高拯妮[1] 陈林艳[1] 何光敏[1] 

机构地区：[1]广东医学院附属医院乳腺外科,湛江524001

出　　处：《国际护理学杂志》2010年第6期831-832,共2页international journal of nursing

摘　　要：目的探讨乳腺癌合并糖尿病围手术期血糖的合理控制。方法回顾分析51例乳腺癌合并糖尿病患者，按胰岛素治疗后术前空腹血糖（FPG）水平分两组。A组FPG〈7．0mmol／L，B组FPG≥7．0mmol／L。比较手术前后FPG、餐后2h血糖（2hPG）、胰岛素日使用量、术前准备时间、伤口拆线时间、酮症酸中毒、低血糖反应和伤口感染的发生率。结果A组手术前后FPG明显低于B组[（6．1±0．8）vs（9．2±1．7），（6．7±2．2）VS（9．8±2．7）]，P〈0．05；A组胰岛素日使用量（45．4±4．6）明显高于B组（37．2±5．1），P〈0．01；且A组术前准备时间（20．5±10．4）也明显长于B组（14．2±8．6），P〈0．05；伤口积液感染的发生率A组1例（4．3％）低于B组7例（25％），P〈0．05；酮症酸中毒发生率A组1例（4．3％）低于B组8例（28．6％），P〈0．01；两组伤口拆线时间和低血糖反应的发生率，差别无统计学意义。结论控制术前血糖接近于正常水平，是提高乳腺癌手术成功率、减少围手术期风险和并发症的关键。Objective To investigate the rehabilitative impact of rational monitoring the blood glucose in patients with mammary cancer complicating diabetic during the perioperative period. Methods A total of 51 patients with mammary cancer complicating diabetic were retrospectively analyzed, and were divided into two group A （FPG 〈7.0 mmol/L） and group B （FPG≥7.0 mmol/L） according to the fasting plasma glucose （FPG） after insulin treatment and before operation. Then the level of FGP before and after operation, 2 hours plasma glucose after meal （2 hPG）, daily dosage of insulin, the preparing time before operation, the sutures out time of wound, the keto- acidosis, hypoglycemia reaction and the incidence rate of wound infection were compared. Results The FPG in group A before and after opertion were obviously lower than those in group B [ （6. 1±0. 8 ） vs （9.2±1.7 ） mmol/L, （6.7±2.2） vs （9. 8 ±2.7 ） mmol/L] （P 〈 0. 05） . The daily dosage of insulin in group A （45.4± 4. 6） was obviously higher than that in group B （37.2±5.1 ） （ P 〈 0. 01 ）. The preparing time before operation of group A （20.5±10. 4） was much longer than that in group B （ 14. 2±8.6） （P 〈0. 05） . The incidence rate of wound infection of group A （ 1 case, 4. 3% ） was lower than that in group B （7 cases, 25% ） （P 〈 0.05） . The incidence rate of ketoacidosis in group A （ 1 case, 4.3% ） was lower than that in group B （8 cases, 28.6% ） （P 〈 0. 01 ） . The incidence rate of the sutures out time of wound and hypoglycemia reaction in the two groups had no significant difference. The complication of experimental group was reduced obviously when compared to that in compared group, and there was significant difference between the two groups （ P 〈 0. 01 ） . While the quality of life of patients in the two groups after interventional therapy as follows ： the scores in the fields of psychol- ogy and mentality had significant difference （P 〈 0. 01 ）, but that

关 键 词：乳腺癌 糖尿病 围手术期 

分 类 号：R473.73[医药卫生—护理学]