胃癌根治术后应激性高血糖与外科感染关系的临床观察  

Clinical observation of stress hyperglycemia and surgical infection after radical gastrectomy

作　　者：秦啸[1] 毛伟征[2] 李谦[2] 李扬[2] 李林浩[2] 吕文平[2] 

机构地区：[1]青岛大学医学院,山东青岛266021 [2]青岛市市立医院东院普外科,山东青岛266021

出　　处：《中国现代普通外科进展》2011年第3期219-221,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:比较B-1式胃癌患者手术前后血糖的变化,探讨其与胰岛素抵抗及外科感染的关系及血糖控制的意义。方法:对82例行B-1式胃癌根治术患者手术前后空腹血糖进行比较,并根据血糖水平,分成血糖浓度正常组和血糖浓度异常组,比较两组术后切口及腹腔感染发生情况,并进行统计学分析。结果:患者术后血糖均有上升,和术前比较有统计学差异,术后血糖≤8.3 mmol/L35例,术后血糖>8.3 mmol/L 47例。术后血糖浓度>8.3 mmol/L的患者较≤8.3 mmol/L患者术后应激性血糖浓度增高明显,切口及腹腔感染发生率显著提升,并发症发生明显增加。结论:胃癌手术应激可引起术后胰岛素抵抗,术后严密的血糖监测和合理、适量的应用胰岛素,是避免患者术后血糖升高的关键。Objective： To investigate the relationship of surgical stress and stress hyperglycemia and surgical infections through compare the blood glucose level of preoperative and postoperative.Mehods： Eight-two gastric cancer patients were divided into two groups by the postoperative blood glucose level.The first group postoperative blood glucose less than 8.3 mmol/L,and the second group postoperative blood glucose more than 8.3 mmol/L.Compare the postoperative incision and celiac infection rate of the two groups.Results： The blood glucose level of postoperative patients is more than preoperative patients.3 patients incision or celiac infection in the first group,15 patients in the second group.The incision and celiac infection rate increased significantly.The differences between the two groups are statistically significant.Conclusion： Surgery stress can cause postoperative insulin resistance.Monitoring the postoperative patients＇ blood glucose,reasonable and proper use insulin is useful for the postoperative patients.

关 键 词：胃肿瘤 外科手术 应激性高血糖 血糖 手术并发症 

分 类 号：R619.3[医药卫生—外科学]