胃癌合并糖尿病圍手術(shù)期處理的臨床觀察.pdf

1、提要目的:目的:本課題旨在運(yùn)用臨床觀察與記錄的方法對(duì)胃癌合并糖尿病患者圍手術(shù)期處理方式進(jìn)行系統(tǒng)深入地收集和整理，從而歸納出能降低術(shù)后并發(fā)癥的發(fā)生率，使患者安全度過(guò)圍手術(shù)期的處理方式。方法方法：對(duì)31例胃癌合并糖尿病患者進(jìn)行術(shù)前飲食管理控制血糖術(shù)后嚴(yán)密觀察病情變化及血糖控制情況合理應(yīng)用抗生素加強(qiáng)營(yíng)養(yǎng)及床邊護(hù)理預(yù)防吻合口瘺及感染。結(jié)果結(jié)果：31例病例中術(shù)后切口裂開(kāi)1例，切口脂肪液化3例，肺部感染1例，吻合口瘺0例。所有病例圍手術(shù)期中未見(jiàn)泌尿

2、系感染、低血糖、糖尿病性酮癥酸中毒等并發(fā)癥，術(shù)后平均住院142d。結(jié)論結(jié)論：胃癌合并糖尿病患者經(jīng)充分術(shù)前準(zhǔn)備在圍手術(shù)期嚴(yán)格控制血糖合理營(yíng)養(yǎng)支持，有效預(yù)防感染，維持內(nèi)環(huán)境穩(wěn)定，則理想的胃癌手術(shù)療效是能實(shí)現(xiàn)的。關(guān)鍵詞糖尿病胃癌圍手術(shù)期；術(shù)后并發(fā)癥1目錄目錄引言...............................................................3臨床觀察及分析.....................

3、....................................41病例來(lái)源............................................................42胃癌合并糖尿病患者的診斷標(biāo)準(zhǔn)........................................43納入標(biāo)準(zhǔn)........................................................

4、....44排除標(biāo)準(zhǔn)............................................................45臨床資料與方法......................................................55.1一般資料........................................................55.2方法：................

5、..........................................56.結(jié)果...............................................................7討論...............................................................81.入院明確診斷，所需血糖的目標(biāo)...........................

6、............81.1診斷需明確：....................................................81.2血糖目標(biāo)：......................................................82.術(shù)前處理...........................................................82.1術(shù)前心理指導(dǎo).......

7、.............................................82.2術(shù)前飲食指導(dǎo)....................................................92.3術(shù)前血糖控制....................................................93.術(shù)中處理............................................

8、..............104.術(shù)后處理..........................................................104.1術(shù)后生命體征及血糖監(jiān)測(cè).........................................104.2術(shù)后胃腸減壓...................................................114.3術(shù)后飲食及營(yíng)養(yǎng)支持治療.....