文档介绍：耳鼻咽喉头颈外科糖尿病患者的围手术期并发症及处理耳鼻咽喉―头颈外科糖尿病患者的围手术期并发症及处理耳鼻咽喉―头颈外科糖尿病患者的围手术期并发症及处理作者:刘新义刘艳张恩东薛令军纪建丽孙瑜宁【摘要】目的探讨糖尿病对耳鼻咽喉―头颈外科患者手术后并发症的影响以及糖尿病患者的围手术期治疗。方法对51例接受耳鼻咽喉及头颈部不同类型手术的糖尿病患者,观察其围手术期并发症,,根据血糖的测定结果,开始剂量约为4~8U;对术后禁食需要补液的患者,按葡萄糖3~4g/胰岛素1U的比例给药,并每日监测血糖指标;术后进流质或半流质饮食的患者,于三餐前皮下注射胰岛素,按血糖测定情况给药,直至围手术期结束。患者术前及术后需用有效的抗生素预防感染,并注意纠正全身各系统的功能紊乱。结果12例患者出现术后并发症(%)。其中术后伤口局部感染4例(%),伤口延期愈合6例(%),2例(%)行全副鼻窦开放术的患者,在取出鼻腔填塞物后出现鼻腔出血,经再次填塞后出血止。未发生肺部感染及术后败血症,亦未发生***症酸中毒及心肺功能不全。所有患者均达到预期的手术目的。结论耳鼻咽喉―头颈外科糖尿病患者在围手术期期间应用胰岛素治疗,安全有效,只要能够合理用药、注意补充营养及维生素、严格局部换药、及时纠正全身各系统的功能紊乱,就能避免手术中的危险性并减少术后并发症的发生。关键词围手术期手术并发症糖尿病胰岛素Perioperativemanagementofotolaryngology-headandnecksurgerypatientswithdiabetesmellitusLiuXinyi,LiuYan,ZhangEndong,&NeckSurgery,WeihaiSecondMunicipalHospital,Weihai,264200.【Abstract】ObjectiveToexploretheinfluenceofdiabetesonotolaryngology―eptingvariousotorlaryngology-headandneck-surgicaloperationwereadopted,eptedregularinsulininjectionsubcutaneouslyhalfanhourbeforethreefirstdosagewasroughly4~8U,ordingtobloodsugarthefastingpatientswhodemandedfluidreplacementpost-operationalˉly,weinfusedsolutioninproportionto1Uinsulin/3~4gglucoseandmonitoredeverydaybloodsugarinthepost-operationalpatientonliquidorsemiliquiddietinjectedinsulinsubcutaneouslybeforethreemeals,ordingtobloodsugarleveluntilendofperioperativeandpost-operationalpatientsneedeffectiveanˉtibioticstopreventinfections,andre