食管贲门癌合并糖尿病的围手术期处理

目的:探讨总结食管贲门癌合并糖尿病的围手术期营养支持和并发症防治经验.方法:回顾分析了本组1976年～2003年7月,74例食管贲门癌合并糖尿病开胸手术病例.结果:本组病例占同期食管贲门癌手术病例的6.1%,总的并发症发生率12.2%(其中肺部感染2例,伤口感染1例,吻合口瘘2例,高渗非酮性昏迷2例及低血糖2例);死亡1例,围手术期死亡率1.4%(肺部感染致呼吸衰竭).结论:食管贲门癌合并糖尿病在其手术中并不少见(6.1%).充分术前准备,加强术中麻醉管理和术后营养支持,有利于降低食管癌、贲门癌合并糖尿病患者围手术期并发症和死亡率.

Perioperative management of esophageal cancer patients concomitent with diabetes

Objective:To explore the perioperative treatment for esophageal cancer patients concomitent with diabetes.Methods:74 operation cases of esophageal and gastric cardia cancer associated with diabetes were analyzed retrospectively from 1976 to July 2003.Results:The occurrence of esophageal and gastric cardia cancer patients concomitent with diabetes was 6.1% among the esophageal cancer operative cases in the same period. The morbidity was 12.2% (including pulmonary infections in 2 cases,incision infection in 1,anastomosis fistula in 2,HHNC in 2 and hypoglycemia in 2 cases).The perioperative mortality was 1.4% with one patient dying of respiratory failure caused by pulmonary infection.Conclusion:Esophageal and gastric cardia cancer patients associated with diabetes are found to be common in thoracic operations (6.1%).It is crucial to control these patients for low morbidity and mortality through enough preparation,satisfactory aneathesial management and good nutrition support perioperatively.