不同胰岛素使用方式对结直肠癌合并糖尿病患者 围术期血糖控制的疗效对比

宋钰

西安交通大学第一附属医院普通外科，陕西 西安，710061

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摘要：

目的 探讨结直肠癌合并糖尿病患者围术期全肠外营养状态下两种常用的血糖控制方法的疗效差异。方法 选取我院行根治性手术治疗且术前诊断为 2型糖尿病的结直肠癌患者 81例，依据入选先后顺序将患者分为试验组（43例）和对照组（38例）。试验组采用胰岛素泵持续泵入胰岛素控制血糖，对照组在配制肠外营养混合液时根据葡萄糖量加入适量的胰岛素。比较两组的临床疗效。结果 术后 4 d内，两组患者血糖水平均无明显差异（P>0.05）；但对照组患者的血糖水平整体波动较大。对照组低血糖及血糖水平高于 11 mmol/L 总发生率明显高于试验组（P<0.05）。两组患者的各并发症发生率及术后恢复时间比较，差异均不显著（P<0.05）。结论 使用胰岛素泵控制血糖较将胰岛素直接加入肠外营养混合液中更加安全有效。

关键词：糖尿病；结直肠癌手术；围手术期；血糖管理

中图分类号：R587.1文献标志码：A文章编号：2096-1413(2018)09-0006-03

Effects comparison of different ways of insulin in the perioperative glycemic
control in patients with colorectal cancer com plicated with diabetes mellitus

SONG Yu
(General Surgery Department,the First Affiliated Hospital of Xi````an Jiaotong University,Xi````an 710061,China)




ABSTRACT: Objective To investigate the therapeutic effects of two common glycemic control methods in patients with colorectal cancer complicated with diabetes mellitus. Methods Eighty-one patients with colorectal cancer diagnosed with type 2 diabetes who underwent radical surgery in our hospital were selected, patients were divided into experimental group (43 cases)and control group (38 cases) according to the admission order. The experimental group used continued insulin pump to control blood sugar, while the control group added appropriate amount of insulin according to the amount of glucose during the preparation of parenteralnutrition mixture.The clinical effects were compared between the two groups. Results The rewasnosignificantdifferencein the blood glucoselevelbetween thetwogroupswithin 4 d after operation (P>0.05); however,the blood glucose level of the control group fluctuated greatly. The total incidence of hypoglycemia and blood glucose levels higher than 11 mmol/L in the control group were significantly higher than those in the experimental group (P<0.05). There were no significant differences in the incidence rate of each complication, postoperative recovery time in thetwogroups (P<0.05).Conclusion Usingthe insulin pump to manage the blood glucoseismoresafe and effective than mixture the insulin with liquid.
KEYWORDS: diabetes mellitus; colorectal cancer surgery; perioperative period; blood glucose management

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