Smiley Dawn D, Umpierrez Guillermo E
Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA 30303, USA.
South Med J. 2006 Jun;99(6):580-9; quiz 590-1. doi: 10.1097/01.smj.0000209366.91803.99.
Patients with diabetes are more likely to undergo surgery than nondiabetics, and maintaining glycemic control in subjects with diabetes can be challenging during the perioperative period. Surgery in diabetic patients is associated with longer hospital stay, higher health care resource utilization, and greater perioperative mortality. In addition, several observational and interventional studies have indicated that hyperglycemia is associated with adverse clinical outcomes in surgical and critically ill patients. This paper reviews the pathophysiology of hyperglycemia during trauma and surgical stress and will provide practical recommendations for the preoperative, intraoperative, and postoperative care of diabetic patients.
糖尿病患者比非糖尿病患者更有可能接受手术，并且在围手术期对糖尿病患者进行血糖控制具有挑战性。糖尿病患者手术与更长的住院时间、更高的医疗资源利用率以及更高的围手术期死亡率相关。此外，多项观察性和干预性研究表明，高血糖与手术患者和危重症患者的不良临床结局相关。本文综述了创伤和手术应激期间高血糖的病理生理学，并将为糖尿病患者的术前、术中和术后护理提供实用建议。
