慢性鼻-鼻窦炎伴糖尿病患者的围手术期血糖控制

目的：探讨慢性鼻-鼻窦炎伴糖尿病（DM）患者在鼻内镜手术围手术期控制血糖的有效方法和临床意义。方法：采用回顾性分析方法，并复习文献进行讨论。22例慢性鼻-鼻窦炎伴DM患者，Ⅰ型DM1例，Ⅱ型DM21例。依研究对象有无眼部并发症分为并发症组（3例）和无并发症组（19例）。并发症组术前采用胰岛素控制血糖，无并发症组术前采用口服降糖药控制血糖。结果：并发症组控制术前血糖〈9．0mmol／L、非并发症组控制术前血糖〈7．0mmol／L后，22例慢性鼻-鼻窦炎患者都行内镜鼻窦手术，术后经鼻内镜常规治疗处理，21例患者治愈，1例明显好转。结论：空腹血糖、尿糖的检查应列为鼻内镜手术前的常规检查，无并发症的Ⅱ型DM，首选口服降糖药控制血糖；Ⅰ型DM、有并发症的Ⅱ型DM，都应首选胰岛素控制血糖。

The perioperative glycemic control in chronic rhinosinusitis coexisting diabetes

Objective:To evaluate the method of the perioperative blood glucose control in chronic rhinosinusitis coexisting diabetes.Method:Twenty-two cases of chronic rhinosinusitis coexisting diabetes were investigated retrospectively,including one case of type 1 diabetes and 21 cases of type 2 diabetes.The study cohort was divided into two groups,the one was complication group and the other was non-complication group.The patients in complication group were injected insulin to control blood glucose level,and the patients in non-complication group were prescribed oral medicine.Result:Blood glucose levels below 9.0 mmol/L in complication group and below 7.0 mmol/L in non-complication group were both the surgical indication for the patients in this research cohort.Twenty-one cases were completely recovered and one case made progress signifcantly.Conclusion:The detection of blood and urine glucose levels must be the routine item before the nasal endoscopic surgery.To control blood glucose levels in type 2 diabetes with non-complication,oral medicine is the first choice,in type 1 diabetes and type 2 diabetes with complication,insulin should be first considered.