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目的探讨总结食管癌、贲门癌合并糖尿病患者的外科治疗。方法回顾分析2009年1月至2010年9月收治的47例食管癌、贲门癌合并糖尿病患者的外科治疗经验。结果手术切除率100%,术后并发切口感染3例,切口液化1例,颈部吻合口瘘1例,肺部感染2例,应激性溃疡1例,脑梗塞1例,其中1例同时合并颈部吻合口瘘、肺部感染和切口感染,并发症发生率14.9%,经积极治疗后全部治愈出院,无手术死亡、酮症酸中毒及高渗性昏迷发生。结论食管癌、贲门癌合并糖尿病患者应首选外科手术治疗,合理应用胰岛素,严格控制血糖水平能使患者安全度过围手术期。
Objective To investigate the surgical treatment of patients with esophageal cancer and cardia cancer with diabetes mellitus. Methods A retrospective analysis of surgical treatment of 47 patients with esophageal and cardiac cancer with diabetes mellitus admitted from January 2009 to September 2010 was performed. Results Surgical resection rate was 100%, postoperative incision infection in 3 cases, incision liquefaction in 1 case, neck anastomotic fistula in 1 case, pulmonary infection in 2 case, stress ulcer in 1 case and cerebral infarction in 1 case, of which 1 case Combined with anastomotic fistula, pulmonary infection and incision infection, the complication rate was 14.9%. After active treatment, all patients were cured, discharged without surgery, and had ketoacidosis and hyperosmolar coma. Conclusion esophageal cancer, cardia cancer patients with diabetes mellitus should be the preferred surgical treatment, rational use of insulin, strict control of blood glucose levels can make the patient safe perioperative period.