González-Avila Gabriel, Medrano-Ortiz de Zárate María Elena, Domínguez-Rojo Socorro
Servicio de Medicina Interna, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.
Rev Med Inst Mex Seguro Soc. 2009 Sep-Oct;47(5):531-8.
The effect of uncontrolled chronic glycemia (UCG) in the diabetic patient with a neoplasm (DPN) has not been evaluated during the early postoperative period. Our objective was to determine the frequency of early surgical complications in the DPN with UCG.
A cohort of 184 consecutive diabetic patients who had a histological malignant diagnosis were studied; they were matched with 184 non-diabetic controls by age, gender, neoplasm type and surgery, those who received chemotherapy or irradiation 30 days before surgery were excluded. Fasting blood glucose, HbA1c, presence of diabetic complications and co-morbidity before surgery; type of surgery and postoperative early morbidity and mortality were measured.
The DPN with UCG had a higher frequency of surgical postoperative complications than their controls. The presence of comorbidity (p < 0.011) and HbA1c > 6.5 % (p < 0.011) were independent and ominous significant predictors.
Preoperative UCG increases the risk of early surgical complications in DPN.
在肿瘤患者合并糖尿病（DPN）的患者中，术后早期未控制的慢性高血糖（UCG）的影响尚未得到评估。我们的目的是确定合并UCG的DPN患者早期手术并发症的发生率。
研究了一组184例经组织学确诊为恶性肿瘤的连续糖尿病患者；根据年龄、性别、肿瘤类型和手术情况将他们与184例非糖尿病对照者进行匹配，排除术前30天接受化疗或放疗的患者。测量术前空腹血糖、糖化血红蛋白、糖尿病并发症的存在情况和合并症；手术类型以及术后早期发病率和死亡率。
合并UCG的DPN患者术后手术并发症的发生率高于对照组。合并症（p < 0.011）和糖化血红蛋白> 6.5%（p < 0.011）是独立且具有显著意义的不良预测因素。
术前UCG会增加DPN患者早期手术并发症的风险。
