摘要
目的探讨胰岛素强化治疗在III-IV期卵巢癌合并2型糖尿病患者治疗中的意义。方法回顾性分析2010年～2015年在宁波市妇女儿童医院行卵巢癌分期手术的III-IV期卵巢癌合并2型糖尿病患者例70例，入院后严格执行饮食及运动方案，依据术前是否行胰岛素强化治疗分为2组，非强化治疗组37例，入院后口服其他降糖药物控制血糖（单药或者联合，如阿卡波糖、二甲双胍及格列齐特等），强化治疗组33例，入院后全部给予单纯胰岛素治疗，2组术前空腹血糖均控制小于11.1mmol/L，分析2组患者住院时间、术后第1天血糖波动水平、术后肠外营养时间、手术后的抗生素使用时间、院内感染发生率、腹部切口愈合不良发生率、血栓性疾病（下肢静脉血栓、脑栓塞等）的发生率，其中依据术前空腹血糖控制的水平，强化治疗组再分为3个亚组（B1、B2、B3），B1组9例血糖控制在4.4～6.1mmol/L之间，B2组13例血糖控制在6.1～8.3mmol/L之间，B3组11例血糖控制在8.3～11.1mmol/L之间。分析不同血糖控制水平亚组术后1w患者的体力状态指数（Performancestatusindex，PSI）变化。结果强化治疗组与非强化治疗组相比，住院时间、手术后第1天血糖波动水平差异有统计学意义（P＜0.05）；肠外营养的时间差异无统计学意义；手术后的抗生素使用时间差异有统计学意义（P＜0.05）；院内感染发生率无统计学意义；腹部切口愈合不良发生率、血栓性疾病（下肢静脉血栓、脑栓死）的发生率有统计学意义(P＜0.05)，强化治疗组各组术后1w体力状态指数B1组与B2组（P＜0.05）、B3组（P＜0.05）有统计学意义，B2、B3组组间差异无统计学意义。结论对于拟行手术治疗的晚期卵巢癌患者，术前给予胰岛素强化治疗，能明显降低手术后并发症的发生，改善患者术后的生存状态，术前血糖控制在6.1mmol/L之内，术
Objective To investigate the effect of intensive insulin therapy on reducing postoperative complications of patients with diabetes who underwent radical operation of ovary cancer.Methods70advanced ovarian cancer patients with diabetes from2010to2015were enrolled and underwent radical operation of ovarian cancer,all of them were treated with strict diet and exercise plan after admission,and divided into two groups by giving intensive insulin therapy(ITT)or not,37cases in the non-enhancement group were treated with other hypoglycemic agent(one or more),the enhancement group was controlled glucose by intensive insulin therapy only,both groups of preoperative fasting glucose kept less than11.1mmol/L.The hospital stays,1st day blood glucose levels after operation,the time of parenteral nutrition and antibiotics consumption,the incidence of nosocomial infection、poor healing of abdominal incisions and thrombotic diseases were analyzed.Then the enhancement group treated with intensive insulin therapy was divided into three subgroups(B1,B2,B3),glucose levels of the B1group were controlled from4.4to6.1mmol/L,glucose levels of the B2Group were controlled from6.1to8.3mmol/L,glucose levels of the group B3were controlled from8.3to11.1mmol/L.The physical state index(Performance status index,PSI)of three groups after the1st postoperative week were investigated.Results Compared with the two groups,there was statistical significance in the hospital stays,the1st day blood glucose levels(P<0.05),there was no statistical significance in parenteral nutrition,antibiotics consumption and the incidence of nosocomial infection between two groups,there was statistical significance in the poor healing of abdominal incisions,and thrombotic diseases(P<0.05).The physical state index of three subgroups,there was statistical significance in the group B1compared with B2and B3group,but no statistical significance between group B2and B3.Conclusion Insulin intensive therapy not only could significantly reduce the complications of patients combined
作者
蔡海瑞
史慧薇
李馨
赵玲军
CAI Hai-rui;SHI Hui-wei;LI Xin;ZHAO Ling-jun(Department of Gynaecological Oncology, Ningbo Women & Children’s Hospital, Ningbo 515012, China)
出处
《中国生化药物杂志》
CAS
2017年第12期212-214,共3页
Chinese Journal of Biochemical Pharmaceutics
关键词
卵巢癌
2型糖尿病
并发症
胰岛素
ovarian cancer
type-2 diabetes mellitus
postoperative complications
insulin
