摘要
目的：探讨糖尿病患者妇科手术的处理原则。方法：对46例糖尿病患者行妇科手术的临床资料进行回顾性分析。31例（61．5％）有糖尿病史，15例（32．6％）入院后检查发现。术前治疗：6例仅控制饮食；38例口服降糖药；2例加用岛胰素。血糖空腹8．3mmol／L．餐后2小时13．88mmol／L以下即进行手术。结果：术后20例血糖正常，30例出现一过性尿酮症性，2例因禁食胃肠减压出现持续性酮症酸中毒和低血钾并经胰岛素调节后恢复正常。全体预后良好出院。结论：糖尿病患者术前应仔细检查并于手术前后积极治疗。对术后禁食胃肠减压者应同时防止低血钾。
Objective: Investigating the principles of perioperative management f0r gynecologic patients withdiabetes mellitus. MethodS: Clinical analysis of 46 diabetic patients with gynecologic surgery was carried outretrospectively. 31 patients were with known diabetes mellitus and 15 were diagnosed after the admission tothe hospital. Preoperatively, diet therapy was given to all patients, of whom 6 were managed with dietalone 38 were treated with additional hypoglycemic agents and 2 were combined with regular insulinadministration. Operation was scheduled under the condition of the fasting and 2-hour postprandial bloodglucose level below 8. 3 and 13. 88 mmol/l respectively. Results: Postoperatively blood glucose level wasmaintained within the normal range in 2O patients while temporary urine ketone was detected in 3O patients,Only 2 patients had consistent ketoacidosis and hypokalemia because of fasting and gastrointestinaldecompression but recovered by the infusion of insulin. No serious complications occurred in this group.Conclusions: Accurate assessment of a diabetic patient prior to surgery is very important. Constant monitoringand active treatment must be given to the patients with diabetes millitus preoperatively and special attentionshould be paid to them with postoperative fasting and gastroinstestinal decompression in order to avoidhypokalemia.
出处
《北京医科大学学报》
CSCD
1997年第4期366-368,共3页
Journal of Peking University(Health Sciences)
关键词
糖尿病
药物疗法
妇科手术
Premedication Diabetes mellitus/drug ther Genitatia, female/surg
