Abstract:

Objective To explore the feasibility of oral glucose intake before surgery in thyroid cancer patients with diabetes for the purpose of decreasing complications and increasing comfort. Methods Between January 2017 and July 2018,98 patients with thyroid cancer and diabetes were selected as the experimental group,and were further randomly divided into two subgroups：experimental group 1 and experimental group 2. Fifty-two patients diagnosed between January 2016 and December 2016 were selected as the control group. Experimental group 1 received preoperative warm water intake,experimental group 2 had preoperative oral 5% glucose intake,and the control group was traditionally abstinent from food and water before surgery. Blood glucose,C reactive protein,throat pain,incision infection,incision healing,indwelling time of plasma drainage tube,thirsty score among three groups were compared. Results For blood glucose,there was significant difference between experimental group 1 and 2（P<0.001）,and there were no differences for the rest. For C reactive protein,there were significant differences among three groups（P<0.05）,a significant difference was found between the control group and experimental group 1 and 2（P<0.05）. For throat pain,there were significant differences between the control group and experimental group 1 and 2,but no significant difference was found between experimental group 1 and 2（P>0.05）. For complications,there were significant differences among three groups in delayed incision healing and thirst（P<0.05）,and no significant difference was found in incision infection（P>0.05）. Conclusion Preoperative oral 5% glucose intake doesn’t increase postoperative blood glucose level among thyroid cancer patients with diabetes,relieves throat pain and thirst,reduces postoperative stress,decreases chances of delayed incision healing.

Key words: Thyroid Neoplasms, Diabetes Mellitus, Glucose, Enhanced Recovery After Surgery, Perioperative Nursing

摘要：

目的 对甲状腺癌合并糖尿病患者术前口服葡萄糖的可行性进行探讨,旨在减少甲状腺癌合并糖尿病患者的术后并发症,提高患者舒适度。 方法 选取2017年1月—2018年7月98例行甲状腺癌手术的糖尿病患者为试验组,采用随机分组法将试验组患者分为试验组1与试验组2,选取2016年1月—12月52例行甲状腺癌手术的糖尿病患者为对照组。试验组1术前口服温开水,试验组2术前口服5%葡萄糖溶液,对照组采取传统的禁食禁水方法。分别比较3组的血糖、血清C反应蛋白、咽喉疼痛程度、切口感染率、切口延迟愈合率等指标。 结果 血糖方面,试验组1及试验组2术晨口服液体2 h后血糖的比较,差异有统计学意义（P<0.001）,其余血糖的比较,差异无统计学意义;血清C反应蛋白方面,3组比较,差异有统计学意义（P<0.05）,对照组术后1 d血清C反应蛋白与试验组1、试验组2比较,差异均有统计学意义（P<0.05）;咽喉疼痛方面,对照组与试验组1、试验组2比较,差异有统计学意义（P<0.05）,试验组1与试验组2比较,差异无统计学意义（P>0.05）;3组切口延迟愈合、口渴状况比较,差异有统计学意义（P<0.05）;3组切口感染发生率比较,差异无统计学意义（P>0.05）。 结论 术前口服5%的葡萄糖溶液不增加甲状腺癌合并糖尿病患者的术后血糖,能减轻患者的咽喉部疼痛与口渴感,能降低术后应激,减少患者切口延迟愈合的发生率。

关键词: 甲状腺肿瘤, 糖尿病, 葡萄糖, 加速康复外科, 围手术期护理