Clinical effects of a good control of blood sugar during perioperative period on surgical tolerance and postoperative recovery in elderly patients with gastric cancer and diabetes / 中华老年医学杂志

ABSTRACT

Objective:To investigate clinical effects of a good control of blood sugar during perioperative period on surgical tolerance and postoperative recovery in elderly patients with gastric cancer and diabetes.Methods:A total of 92 elderly patients with gastric cancer and diabetes undergoing surgery in our hospital from August 2018 to March 2020 were randomly divided into a control group(taking conventional perioperative care, n=46)and an observation group(taking conventional perioperative care and good glycemic control, n=46). The changes of perioperative blood glucose level, surgical conditions and postoperative recovery in the two groups were observed and analyzed.Results:Fasting blood glucose level of observation group and control group was[(7.4±1.1)mmol/L vs.(7.9±1.3)mmol/L, t=-1.991, P=0.025]at 1 d before operation, [(7.2±0.9)mmol/L vs.(8.7±1.2)mmol/L, t=-6.782, P=0.000]during operation, and[(6.9±1.5)mmol/L vs.(8.5±1.1)mmol/L, t=-5.834, P=0.000]after operation.Anyway, fasting blood glucose level was lower in the observation group than in the control group.In observation vs control group, time of incision healing[(7.5±1.6)d vs.(9.7±2.2)d, t=-5.485, P=0.000], time to get out of bed[(3.3±0.8)d vs.(4.7±1.3)d, t=-6.221, P=0.000], length of stay in hospital[(10.5±2.7)d vs.(15.1±3.5)d, t=-7.058, P=0.000]were shorter in observation group than in control group.The incidence of postoperative complications was lower in the observation group than in the control group(8.70% vs.26.09%, χ2=4.484, P=0.028). Conclusions:The application of perioperative glycemic control can effectively maintain the perioperative blood glucose at a reasonable and stable level, improve the surgical tolerance and promote the postoperative recovery in elderly patients with gastric cancer and diabetes.And it plays a very positive role in ensuring the safety of surgery