良性梗阻性黄疸合并糖尿病31（）例分析  

Clinical analysis of 310 cases of benign obstructive jaundice complicated with diabetes meilitus

作　　者：马中林[1] 沈世强[1] 陈祖兵[1] 林福生[1] 闫瑞承[1] 任波[1] 胡超[1] 

机构地区：[1]武汉大学人民医院肝胆外科,430060

出　　处：《腹部外科》2011年第4期219-221,共3页Journal of Abdominal Surgery

摘　　要：目的探讨良性梗阻性黄疸合并糖尿病闸手术期治疗措施。方法对2006年1月至2010年12月收治的310例良性梗阻性黄疸合并糖尿病择期手术病例进行网顾性分析。结果手术前日空腹血糖控制在4．5～7．8mmol／L182例，术后发生并发症47例（25．8％）；控制在7．8～10．01mmol／L128例，术后发生并发症40例（31．2％），两相比较差异没有统计学意义。术中血糖控制在6．3～11．1mmol／L。术后血糖控制存5．6～7．8nmaol／L132例，发生并发症20例（15．1％）；控制在7．8～11．1mmol／L178例，发生并发症67例（37．6％），两相比较筹异有统计学意义（P〈0．05）。黄疸程度与血糖交互作用归因比（AIP）=0．25，95%可信区间在0．14～1．02，表明两者在并发症中存在交互作川。结论强化图手术期治疗，并将术后血糖控制在7．8mmol／L，以下可显着降低术后并发症发生率。黄疸程度在术后并发症方面与血糖存在交互作用。Objective To investigate the perioperative management of benign obstructive jaundice complicated with diabetes mellitus. Methods The clinical data of 310 patients with benign obstructive jaun dice complicated with diabetes mellitus in the recent five years in our hospital were＇ analyzed retrospectively. Results Preoperative fasting blood glucose levels were controlled between 4. 5-7. 8 rnmol/L in 182 cases, and postoperative complications occurred in 47 cases（25, 8% ）;between 7. 8- 10 rnnlol/L in 128 cases, and postoperative complications occurred in 40 cases （31.2 % ）. Intra-opcrative blood glucose levels were con trolled between 6. 3-11.1 mMol/L. Postoperative glucose controlled between 5. 6-7. 8 mmol/L in 132 cases, and complications occurred in 20 cases（15. 1%）, between 7.8 -11.1 mmol/L in 178 cases, and conlplications occurred in 67 cases（37. 6 %）（P〈-~.{）. {）5）. Attributable proportions of interaction（AlP） = 0. 25, and 95 C1 = 0. 14 1.02, suggesting the existence of interaction between j atmdice degree and glucose levels. Conclusion Strengthening perioperative management and controlling 1he postoperative blood glucose levels below 7. 8 mmol/L can significantly reduce the incidence of postoperative complications. There is interaction between jaundice degree and blood glucose levels.

关 键 词：糖尿病 黄疸 阻塞降 围手术期医护 

分 类 号：R575[医药卫生—消化系统]