陈尔东 谢保玉 黄丽娟

[摘要] 目的 探讨糖尿病患者肛肠手术的体会。方法 将该院80例接受手术治疗的糖尿病肛肠疾病患者纳入研究，对象选取时间为2017年2月—2019年6月，对患者的手术治疗与围术期护理情况作回顾性分析，了解患者术前准备、麻醉过程、手术过程、术后治疗过程、治疗效果。 结果 所有患者均成功完成手术，患者围术期生命体征较为稳定，未出现明显体征波动状况。术后仅1例患者出现切口感染状况，均未出现脑出血、心肌梗死等严重并发症。患者切口愈合时间为12～32 d，平均（20.1±2.4）d。患者血糖控制稳定，术前平均血糖值控制在（7.04±2.24）mmol/L，术后平均血糖值控制在（8.11±1.76）mmol/L。结论 糖尿病患者肛肠手术围术期需加强对患者的血糖控制，以保证手术顺利实施，减少术后严重并发症的出现。

[关键词] 糖尿病;肛肠;手术;麻醉

[中图分类号] R587.1; R657.16          [文献标识码] A          [文章编号] 1672-4062（2020）05（b）-0031-03

Experience of 80 Cases of Anorectal Surgery in Diabetic Patients

CHEN Er-dong， XIE Bao-yu， HUANG Li-juan

Department of Anorectal Diseases， Zhangzhou Hospital of Traditional Chinese Medicine， Zhangzhou， Fujian Province， 363000 China

[Abstract] Objective To explore the experience of anorectal surgery in patients with diabetes. Methods Eighty patients with diabetic anorectal disease who underwent surgical treatment in our hospital were included in the study. The subjects were selected from February 2017 to June 2019. A retrospective analysis was performed on the surgical treatment and perioperative care of the patients to understand the patient's operation pre-preparation， anesthesia process， surgery process， post-operative treatment process， treatment effect. Results All patients successfully completed the operation. The vital signs of the patients during the perioperative period were relatively stable， and there was no obvious sign fluctuation. Incision infection occurred in only one patient after operation， and no serious complications such as cerebral hemorrhage and myocardial infarction occurred. The incision healing time was 12-32 d， with an average of （20.1±2.4）d. The patient's blood glucose control was stable， the average blood glucose value before operation was controlled at （7.04±2.24）mmol/L， and the average blood glucose value after operation was controlled at （8.11±1.76）mmol/L. Conclusion During the perioperative period of anorectal surgery for diabetic patients， it is necessary to strengthen the blood glucose control of the patients to ensure the smooth implementation of the operation and reduce the occurrence of serious complications after surgery.

[Key words] Diabetes; Anorectal; Surgery; Anesthesia

糖尿病是臨床最为常见的慢性病之一，糖尿病患者表现为高血糖特征，常导致患者出现疲乏无力、消瘦、多尿、多饮等症状，且持续高血糖状态还会影响机体功能，严重时将导致心脑血管疾病、机体多脏器功能损伤，引起严重并发症，甚至危及患者生命安全。目前人们不良生活习惯及不良饮食习惯增多，导致肛肠疾病发生率明显升高。手术治疗是临床治疗肛肠疾病的常用方式，但对于合并糖尿病的肛肠患者而言，高血糖的出现将会影响患者体征稳定性，影响手术过程的顺利实施，且高血糖还会增加患者术后并发症风险，影响患者术后恢复过程，延长住院时间，增加治疗经济负担。……