胰腺癌围手术期患者高血糖管理的研究进展
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摘要
胰腺癌围手术期高血糖会增加患者术后并发症发生率及围手术期病死率,充分认识胰腺癌围术期高血糖的危害并积极采取各种方式进行干预,将血糖控制在一定目标范围内,对于保障胰腺癌围手术期安全具有重要意义。本文就胰腺癌围手术期血糖管理相关问题如胰腺癌围术期高血糖的危害、处理、不良反应等方面进行综述,旨在寻找适合临床的血糖管理策略,预防因血糖紊乱引起的并发症,促进患者快速康复。
引文
[1]Chen W,Zheng R,Zhang S,et al.Cancer incidence and mortality in China in 2013:an analysis based on urbanization level[J].Chin J Cancer Res,2017,29(1):1-10.
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[3]Alexanian S M,McDonnell M E,Akhtar S.Creating a perioperative glycemic control program[J].Anesthesiol Res Pract,2011,2011:465974.
[4]Raju T A,Torjman M C,Goldberg M E.Perioperative blood glucose monitoring in the general surgical population[J].Diabetes Sci Technol,2009,3(6):1282-1287.
[5]Pomposelli J J,Baxter J K,Babineau T J,et al.Earlypostoperative glucose control predicts nosocomial infection rate in diabetic patients[J].JPEN J Parenter Enteral Nutr,1998,22(2):77-81.
[6]赵战强,王龙鑫,姜洪池,等.胰十二指肠切除术后胃排空障碍危险因素分析[J].中国实用外科志,2016,36(8):897-899
[7]Sfteland E,Brock C,Frkjr J B,et al.Rectal sensitivity in diabetes patients with symptoms of gastroparesis[J].JDiabetes Res,2014,2014:784-841.
[8]Bharucha A E,Batey-Schaefer B,Cleary P A,et al.Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus[J].Gastroenterology,2015,149(2):330-339.
[9]Bernard C E,Gibbons S J,Mann I S,et al.Association of low numbers of CD206-positive cells with loss of ICC in the gastric body of patients with diabetic gastroparesis[J].Neurogastroenterol Motil,2014,26(9):1275-1284.
[10]Moghissi E S.Addressing hyperglycemia from hospital admission to discharge[J].Curr Med Res Opin,2010,26(3):589.
[11]钱家鸣,杨红.胰腺癌早期诊断及筛查中的问题及进展[J].实用医院临床杂志,2011,8(1):2-4.
[12]纪涛,刘随意,翟骁,等.住院医生血糖管理能力的调查分析[J].第二军医大学学报,2014,35(9):1020-1023.
[13]杨文娟,赖敬波,明洁,等.某三甲医院各科室临床医生糖尿病知识调查[J].实用医院临床杂志,2014,11(2):69-72.
[14]陈玉凤.南京市区三甲医院住院患者血糖管理多中心调查[J].临床合理用药,2017,10(8):14-15
[15]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-942.
[16]O'Neill F,Carter E,Pink N,et al.Routine preoperative tests for elective surgery:summary of updated NICE guidance[J].BMJ,2016,354:i3292.
[17]姜静.胰腺癌与糖尿病关系的研究进展[J].临床合理用药,2017,10(9):180-181
[18]杨飞,许樟荣,胡成伟,等.糖尿病对腹部外科手术的影响[J].中国糖尿病杂志,2002,10(5):268-272.
[19]苗毅.糖尿病患者行胰腺手术时的围手术期处理[J].中国实用外科杂志,2006,26(2):89-91.
[20]Rosa J A,Van-Linda B M,Abourizk N N.New-onset diabetes mellitus as a harbinger of pancreatic carcinoma.Acase report and literature review[J].J Clin Gastroenterol,1989,11(2):211-215.
[21]Aggarwal G,Ramachandran V,Javeed N,et al.Adrenomedullin is up-regulated in patients with pancreatic cancer and causes insulin resistance inβcells and mice[J].Gastroenterology,2012,143(6):1510-1517.
[22]Ezzat S,Zheng L,Florez J C,et al.The cancer-associa-ted FGFR4-G388R polymorphism enhances pancreatic insulin secretion and modifies the risk of diabetes[J].Cell Metab,2013,17(6):929-940.
[23]2012年欧洲关于胰十二指肠切除术后快速康复指南[J].肝胆外科杂志,2013,21(4):317-320
[24]Zauner A,Nimmerrichter P,Anderwald C,et al.Seve-rity of insulin resistance in critically ill medical patients[J].Metabolism,2007,56(1):1-5.
[25]Losser M R,Damoisel C,Payen D.Bench-to-bedside review:glucose and stress conditions in the intensive care unit[J].Crit Care,2010,14(4):231-242.
[26]陈旭东,张雯雯,王宏光,等.围手术期胰岛素抵抗与肝胆胰手术创伤程度的关系[J].解放军医学院学报,2017,38(4):320-322
[27]孙薇,陈阳.肠内、外营养对胰腺癌合并糖尿病术后恢复的作用[J].国际护理学杂志,2016,35(14):1927-1929.
[28]叶倩,付欢英,陈灵燕,等.术后护理措施在胰腺癌合并2型糖尿病患者中的应用[J].临床医学研究与实践,2016,1(11):142-144.
[29]王慧芳.糖尿病合并胰腺癌患者的术后护理探讨[J].糖尿病新世界,2016,19(23):173-174.
[30]Tanaka T,Nabatame H,Tanifuji Y.Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentration-independent manner[J].J Anesth,2005,19(4):277-281.
[31]围手术期血糖管理医-药专家共识[J].今日药学,2018,28(2):73-82.
[32]中华医学会麻醉学分会.围手术期血糖管理专家共识[J].临床麻醉学杂志,2016,32(1):93-95.
[33]Raju T A,Torjman M C,Goldberg M E.Perioperative blood glucose monitoring in the general surgical population[J].J Diabetes Sci Technol,2009,3(6):1282-1287.
[34]中华医学会糖尿病学分会.中国胰岛素泵治疗指南(2014版)[C].重庆:第十三次全国内分泌学学术会议,2017:1-40.
[35]何智,吴英.两种方法控制胰腺癌术后高血糖的效果比较研究[J].检验医学与临床,2016,13(20):2931-2932.
[36]史亚平.多次皮下注射法与持续静脉泵注法注射胰岛素治疗2型糖尿病的临床疗效及相关护理风险[J].临床合理用药2017,10(8):14-15
[37]罗桃.胰岛素不同注射方式治疗糖尿病的护理风险分析[J].现代诊断与治疗,2014,33(20):4783-4785.
[38]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
[39]NICE-SUGAR Study Investigators.Intensive versus conventional glucose control in critically ill patients[J].N Engl JMed,2009,360(13):1283.
[40]徐芬娟,沈飞霞.血糖波动的研究进展[J].中国糖尿病杂志,2014,22(9):852-854.
[41]周亚敏,余燕子,冯翠华,等.ICU两种血糖控制方案的比较研究[J].护理学杂志,2015,30(11):1-4.
[42]Devries J H.Glucose variability:where it is important and how to measure it[J].Diabetes,2013,62(5):1405-1408.
[43]代莉莉,张凤芝,段艳芹,等.2型糖尿病患者血糖的规范化管理[J].护理学杂志,2014,29(23):26-28.
[44]Egi M,Bellomo R.Reducing glycemic variability in intensive care unit patients:a new therapeutic target[J].J Diabetes Sci Technol,2009,3(6):1302.
[45]穆东亮,敖虎山.非体外循环冠状动脉旁路移植术患者术中血糖波动水平与短期预后的关系[J].中华麻醉学杂志,2011,31(2):141-143.
[2]Shrikhande S V,Qureshi S S,Rajneesh N,et al.Pancreatic anastomoses after pancreaticoduodenectomy,do we need further studies?[J].World J Surg,2005,29(12):1642-1649.
[3]Alexanian S M,McDonnell M E,Akhtar S.Creating a perioperative glycemic control program[J].Anesthesiol Res Pract,2011,2011:465974.
[4]Raju T A,Torjman M C,Goldberg M E.Perioperative blood glucose monitoring in the general surgical population[J].Diabetes Sci Technol,2009,3(6):1282-1287.
[5]Pomposelli J J,Baxter J K,Babineau T J,et al.Earlypostoperative glucose control predicts nosocomial infection rate in diabetic patients[J].JPEN J Parenter Enteral Nutr,1998,22(2):77-81.
[6]赵战强,王龙鑫,姜洪池,等.胰十二指肠切除术后胃排空障碍危险因素分析[J].中国实用外科志,2016,36(8):897-899
[7]Sfteland E,Brock C,Frkjr J B,et al.Rectal sensitivity in diabetes patients with symptoms of gastroparesis[J].JDiabetes Res,2014,2014:784-841.
[8]Bharucha A E,Batey-Schaefer B,Cleary P A,et al.Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus[J].Gastroenterology,2015,149(2):330-339.
[9]Bernard C E,Gibbons S J,Mann I S,et al.Association of low numbers of CD206-positive cells with loss of ICC in the gastric body of patients with diabetic gastroparesis[J].Neurogastroenterol Motil,2014,26(9):1275-1284.
[10]Moghissi E S.Addressing hyperglycemia from hospital admission to discharge[J].Curr Med Res Opin,2010,26(3):589.
[11]钱家鸣,杨红.胰腺癌早期诊断及筛查中的问题及进展[J].实用医院临床杂志,2011,8(1):2-4.
[12]纪涛,刘随意,翟骁,等.住院医生血糖管理能力的调查分析[J].第二军医大学学报,2014,35(9):1020-1023.
[13]杨文娟,赖敬波,明洁,等.某三甲医院各科室临床医生糖尿病知识调查[J].实用医院临床杂志,2014,11(2):69-72.
[14]陈玉凤.南京市区三甲医院住院患者血糖管理多中心调查[J].临床合理用药,2017,10(8):14-15
[15]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-942.
[16]O'Neill F,Carter E,Pink N,et al.Routine preoperative tests for elective surgery:summary of updated NICE guidance[J].BMJ,2016,354:i3292.
[17]姜静.胰腺癌与糖尿病关系的研究进展[J].临床合理用药,2017,10(9):180-181
[18]杨飞,许樟荣,胡成伟,等.糖尿病对腹部外科手术的影响[J].中国糖尿病杂志,2002,10(5):268-272.
[19]苗毅.糖尿病患者行胰腺手术时的围手术期处理[J].中国实用外科杂志,2006,26(2):89-91.
[20]Rosa J A,Van-Linda B M,Abourizk N N.New-onset diabetes mellitus as a harbinger of pancreatic carcinoma.Acase report and literature review[J].J Clin Gastroenterol,1989,11(2):211-215.
[21]Aggarwal G,Ramachandran V,Javeed N,et al.Adrenomedullin is up-regulated in patients with pancreatic cancer and causes insulin resistance inβcells and mice[J].Gastroenterology,2012,143(6):1510-1517.
[22]Ezzat S,Zheng L,Florez J C,et al.The cancer-associa-ted FGFR4-G388R polymorphism enhances pancreatic insulin secretion and modifies the risk of diabetes[J].Cell Metab,2013,17(6):929-940.
[23]2012年欧洲关于胰十二指肠切除术后快速康复指南[J].肝胆外科杂志,2013,21(4):317-320
[24]Zauner A,Nimmerrichter P,Anderwald C,et al.Seve-rity of insulin resistance in critically ill medical patients[J].Metabolism,2007,56(1):1-5.
[25]Losser M R,Damoisel C,Payen D.Bench-to-bedside review:glucose and stress conditions in the intensive care unit[J].Crit Care,2010,14(4):231-242.
[26]陈旭东,张雯雯,王宏光,等.围手术期胰岛素抵抗与肝胆胰手术创伤程度的关系[J].解放军医学院学报,2017,38(4):320-322
[27]孙薇,陈阳.肠内、外营养对胰腺癌合并糖尿病术后恢复的作用[J].国际护理学杂志,2016,35(14):1927-1929.
[28]叶倩,付欢英,陈灵燕,等.术后护理措施在胰腺癌合并2型糖尿病患者中的应用[J].临床医学研究与实践,2016,1(11):142-144.
[29]王慧芳.糖尿病合并胰腺癌患者的术后护理探讨[J].糖尿病新世界,2016,19(23):173-174.
[30]Tanaka T,Nabatame H,Tanifuji Y.Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentration-independent manner[J].J Anesth,2005,19(4):277-281.
[31]围手术期血糖管理医-药专家共识[J].今日药学,2018,28(2):73-82.
[32]中华医学会麻醉学分会.围手术期血糖管理专家共识[J].临床麻醉学杂志,2016,32(1):93-95.
[33]Raju T A,Torjman M C,Goldberg M E.Perioperative blood glucose monitoring in the general surgical population[J].J Diabetes Sci Technol,2009,3(6):1282-1287.
[34]中华医学会糖尿病学分会.中国胰岛素泵治疗指南(2014版)[C].重庆:第十三次全国内分泌学学术会议,2017:1-40.
[35]何智,吴英.两种方法控制胰腺癌术后高血糖的效果比较研究[J].检验医学与临床,2016,13(20):2931-2932.
[36]史亚平.多次皮下注射法与持续静脉泵注法注射胰岛素治疗2型糖尿病的临床疗效及相关护理风险[J].临床合理用药2017,10(8):14-15
[37]罗桃.胰岛素不同注射方式治疗糖尿病的护理风险分析[J].现代诊断与治疗,2014,33(20):4783-4785.
[38]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
[39]NICE-SUGAR Study Investigators.Intensive versus conventional glucose control in critically ill patients[J].N Engl JMed,2009,360(13):1283.
[40]徐芬娟,沈飞霞.血糖波动的研究进展[J].中国糖尿病杂志,2014,22(9):852-854.
[41]周亚敏,余燕子,冯翠华,等.ICU两种血糖控制方案的比较研究[J].护理学杂志,2015,30(11):1-4.
[42]Devries J H.Glucose variability:where it is important and how to measure it[J].Diabetes,2013,62(5):1405-1408.
[43]代莉莉,张凤芝,段艳芹,等.2型糖尿病患者血糖的规范化管理[J].护理学杂志,2014,29(23):26-28.
[44]Egi M,Bellomo R.Reducing glycemic variability in intensive care unit patients:a new therapeutic target[J].J Diabetes Sci Technol,2009,3(6):1302.
[45]穆东亮,敖虎山.非体外循环冠状动脉旁路移植术患者术中血糖波动水平与短期预后的关系[J].中华麻醉学杂志,2011,31(2):141-143.