【摘要】 目的 探讨糖尿病对胆道手术的影响及控制血糖的有效方法。 方法 通过设立严格的病例对照，比较40例糖尿病患者与非糖尿病患者、胰岛素强化治疗与非强化治疗胆道术后并发症的发生率。结果 糖尿病显著增加胆道术后并发症的发生率，围手术期胰岛素强化治疗，可减少并发症的发生。 结论 高血糖是胆道病患者术后并发症高发生率的主要原因，严密监测血糖、尿糖，规范围手术期胰岛素强化治疗是预防术后并发症的关键。

    【关键词】 糖尿病；胰岛素；胆道疾病；术后并发症

    Influence and treatment of diabetes mellitus on biliary tract surgery

    LI Nan,YANG Jia-he,LIU Kai,et al.

    Eastern Hepatobiliary Surgery Hospital of SMMU,Shanghai 200438,China

    【Abstract】 Objective To investigate the influence of diabetes mellitus on biliary tract surgery and the methods of control the blood glucose.Methods A case-control study of 40 diabetics receiving operations for biliary tract diseases was undertaken.Patients were matched for mode of operation,age,gender and preoperative coexisting diseases with non-diabetic control.Their morbidity of postoperative complications was compared.Results Postoperative morbidity was increased by diabetes mellitus and decreased by perioperative intensifying therapy with insulin.Conclusion Hyperglycemia was the main reason for high postoperative morbidity of biliary tract surgery.The strict monitoration of blood and urine glucose and standardization of perioperative intensifying therapy with insulin are key to the prevention of postoperative complications. ......