高血糖是乳腺癌术后手术部位感染的危险因素

潮水

American Journal of Infection Control Volume 36, Issue 3, Pages 192-198 (April 2008)

Hyperglycemia as a risk factor for surgical site infections in patients undergoing mastectomy

Diana Vilar-Compte, MD, MsCa, Inés Álvarez de Iturbe, MDa, Alexandra Martín-Onraet, MDa, Maricruz Pérez-Amador, MDb, Claudia Sánchez-Hernández, MDa, Patricia Volkow, MDa


published online 31 January 2008.

Background
The aim of this study was to evaluate the association between perioperative hyperglycemia and surgical site infections (SSIs) in patients undergoing mastectomy.

Methods
In this nested case-control study, patients undergoing mastectomy from May 2004 to June 2006, at the National Cancer Institute (INCan), Mexico, were included. Five blood glucose values were obtained for each patient. Patients were followed prospectively by direct observation for at least 30 days.

Results
A total of 260 patients were included. Patient characteristics were similar in cases and controls. Cases were older (>50 years) (P = .001) and were more frequently treated with concomitant chemoradiation (P < .0001) than controls. Fifty cases (23.8%) developed an SSI. At least 1 measurement of blood glucose value ≥ 150 mg/dL increased the risk for SSI (odds ratio [OR] = 3.05; 95% confidence interval [CI] = 1.5 to 6.3; P = .006). Variables associated with SSI after logistic regression analysis included age >50 years (OR = 3.7; 95% CI = 1.5 to 9.2; P = .005), preoperative concomitant chemoradiation treatment (OR = 2.8; 95% CI = 1.4 to 5.8, P = .0004), and any blood glucose value ≥ 150 mg/dL (OR = 2.9, 95% CI = 1.2 to 6.2; P = .02).

Conclusion
Postoperative SSI was a very frequent complication in this cohort. Our data indicate that higher blood glucose values are an independent risk factor for postoperative SSI. Preoperative concomitant chemoradiation and age > 50 years were also risk factors for developing an SSI in patients undergoing mastectomy.

David

文在此，哈哈！:ok

桂花香

谢提供！
血糖高是手术后感染的独立危险因素，手术前的化疗放疗以及年龄大于50岁也是接受乳房切除术患者发生SSI的危险因素。控制血糖水平很重要哦。

星火

否对术前血糖高进行控制?用胰岛素可以吗?

桂花香

术前控制血糖水平是必要的。但采取什么方法，这得看血糖高的原因吧?如果诊断糖尿病，应该按照其分型采用相应的治疗方法，如果有其他诱因，则需去除。请内分泌专家会诊吧。

星火

好的方法!
见一病区(肝胆外科)常规使用胰岛素在术前,不知道为什么?与SSI有关系否?

桂花香

问医师使用的原因？

safihu

原帖由 zhangfh 于 2008-3-30 09:54 发表

                               
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很好的方法!
见一病区(肝胆外科)常规使用胰岛素在术前,不知道为什么?与SSI有关系否?

控制血糖重要也不用常规都用胰岛素吧。我们监测肝胆外科手术倒没有发现。