Thompson Bithika M, Stearns Joshua D, Apsey Heidi A, Schlinkert Richard T, Cook Curtiss B
Division of Endocrinology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Department of Anesthesiology, Mayo Clinic Hospital, Phoenix, AZ, USA.
Curr Diab Rep. 2016 Jan;16(1):2. doi: 10.1007/s11892-015-0700-8.
Diabetes mellitus (DM) and hyperglycemia are associated with increased surgical morbidity and mortality. Hyperglycemia is a determinant of risk of surgical complications and should be addressed across the continuum of surgical care. While data support the need to address hyperglycemia in patients with DM in the ambulatory setting prior to surgery and in the inpatient setting, data are less certain about hyperglycemia occurring during the perioperative period-that part of the process occurring on the day of surgery itself. The definition of "perioperative" varies in the literature. This paper proposes a standardized definition for the perioperative period as spanning the time of patient admission to the preoperative area through discharge from the recovery area. Available information about the impact of perioperative hyperglycemia on surgical outcomes within the framework of that definition is summarized, and the authors' approach to standardizing perioperative care for patients with DM is outlined, including the special case of patients receiving insulin pump therapy. The discussion is limited to adult ambulatory non-obstetric patients undergoing elective surgical procedures under general anesthesia.
糖尿病（DM）和高血糖与手术发病率和死亡率增加相关。高血糖是手术并发症风险的一个决定因素，应在整个手术护理过程中加以处理。虽然有数据支持在手术前的门诊环境以及住院环境中对糖尿病患者的高血糖进行处理，但关于围手术期发生的高血糖（即手术当天本身过程中的那部分）的数据尚不明确。“围手术期”的定义在文献中有所不同。本文提出围手术期的标准化定义为从患者进入术前区域到从恢复区域出院的时间段。总结了在该定义框架内围手术期高血糖对手术结果影响的现有信息，并概述了作者对糖尿病患者围手术期护理进行标准化的方法，包括接受胰岛素泵治疗患者的特殊情况。讨论仅限于在全身麻醉下接受择期手术的成年门诊非产科患者。
