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目的:探讨食管癌合并糖尿病的围手术期处理方法和外科治疗效果,为该病的临床治疗提供指导。方法:对49例食管癌合并糖尿病患者,采用控制血糖结合手术切除肿瘤治疗;选取49例同期非糖尿病食管癌患者做参比。手术前后采取个性化心理护理,分析比较两组的治疗效果。结果:所有患者手术切除率为100%,无围手术期死亡。食管癌合并糖尿病组术后并发症7例,包括吻合口瘘2例,肺部感染2例,单纯脓胸1例,切口感染2例,均经治疗后痊愈;同期非糖尿病食管癌组手术并发症2例:肺部感染1例,切口感染1例。采用个性化心理护理前后,两组患者的消极、焦虑、恐惧等不良心理得到明显的缓解,对手术效果及围手术期处理效果总满意度达95%。结论:糖尿病引起代谢紊乱易发生愈合不良及各种感染,使术后并发症发生率显著高于同期非糖尿病患者。因此在合并糖尿病的食管癌外科治疗中,围手术期处理至关重要。
Objective: To investigate the perioperative management and surgical treatment of esophageal cancer complicated with diabetes and provide guidance for the clinical treatment of the disease. Methods: Forty-nine patients with esophageal cancer complicated with diabetes were treated with blood glucose control combined with surgical resection. Forty-nine patients with non-diabetic esophageal cancer were selected as reference. Before and after surgery to take personalized psychological care, analysis and comparison of the two groups of treatment. Results: Surgical resection was performed in 100% of all patients without perioperative death. Seven cases of postoperative complications of esophageal cancer with diabetes group, including anastomotic fistula in 2 cases, 2 cases of pulmonary infection, simple empyema in 1 case, incision infection in 2 cases, were cured after treatment; the same period non-diabetic esophageal cancer group complicated by surgery 2 cases of disease: 1 case of lung infection, incision infection in 1 case. Before and after using personalized psychological care, negative, anxiety, fear and other adverse psychological symptoms were significantly relieved in both groups, with a total satisfaction of 95% for the surgical effect and perioperative management. Conclusion: Diabetes mellitus caused metabolic disorders prone to poor healing and various infections, the incidence of postoperative complications was significantly higher than non-diabetic patients in the same period. Therefore, in the surgical treatment of esophageal cancer with diabetes, the perioperative management is essential.