消化道恶性肿瘤患者围手术期血糖水平与术后并发症、住院费用、住院天数关系
Correlation of early postoperative blood glucose levels with postoperative complications, hospital costs, and length of hospital stay in patients with gastrointestinal malignancies
【摘要】 目的 探讨未诊断为糖尿病的消化道恶性肿瘤患者围手术期高血糖对术后并发症及住院费用、住院天数的影响。方法 回顾性分析2010年1月-2010年12月未诊断糖尿病的于我院肿瘤外科手术治疗的1015例临床资料完整的消化道肿瘤患者，术前空腹血糖、肝功、肾功能及术后第一天血糖、肝功、肾功能指标，明确未诊断为糖尿病的消化道肿瘤患者围手术期血糖水平与术后并发症、住院费用、住院天数的关系。结果 术后第一天血糖超过6.1mmol/L占79.0%，超过7.0mmol/L占60.4%，显著高于术前高血糖的发生率。术后第一天血糖水平高于9.13mmol/L，明显增加了住院时间、住院费用和术后并发症发生率。结论 未诊断糖尿病的消化道恶性肿瘤患者如果术后第一天血糖超过9.13mmol/L，需加强监测，并于必要时进行降糖干预，以减少术后并发症发生率，缩短住院周期，降低患者经济负担。
【关键词】围手术期；应激高血糖；高血糖；并发症
[Abstract] Early postoperative hyperglycemia in non-diabetic patients is an important risk factor affecting postoperative complications and mortality. This study aimed at investigating the effects of early postoperative hyperglycemia on postoperative complications, hospital costs, and length of hospital stay in non-diabetic patients with gastrointestinal malignancies. Data of 1,015 non-diabetic patients with gastrointestinal malignancies, who underwent surgical intervention between January 2010 and January 2012, were retrospectively evaluated. Records on fasting plasma glucose (FPG), liver function, and kidney function were collected before and one day after surgery. Correlation of early postoperative FPG levels with postoperative complications, hospital costs, and length of hospital stay was further assessed in non-diabetic patients with gastrointestinal malignancies. One day after surgery, FPG results were significantly increased compared to preoperative values. FPG levels greater than or equal to 9.13 mmol/L (or 164.34 mg/dL) were associated with significant increases in the incidence of postoperative complications, length of hospital stay, and hospital costs. An association is shown between FPG and postoperative hyperglycemia in non-diabetic patients undergoing surgery for gastrointestinal malignancies. Significant increases in postoperative complications among these patients suggest that measurement of early postoperative FPG levels is critical to identify patients with postoperative hyperglycemia.
(本文发表于Endocrine)
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