DIABETES MELLİTUSLU HASTALARDA, CERRAHİ GİRİŞİM ESNASINDA UYGULADIĞIMIZ İNTERMİTTAN, İ.V. İNSÜLİN İNFÜZYONU YÖNTEMİ

Abstract

A.Ü. Tıp Fakültesi Endokrinoloji klinik ve polikliniğinde takibedilen ve cerrahi girişime tabi tutulan 79 diabetes mellitus'lu hastada pre, per ve post-operatuvar periodda uygulanan intermittan insülin infüzyonu yöntemi ayrıntılariyle arzedildi.Gözlenen 4 ölüm vakasının sebepleri, yöntemin avantajları ve mahzurları tartışıldı.

Keywords

• Diyabet ve cerrahi
• İnsülin tedavisi
• Perioperatif komplikasyonlar

Intermıttant, I.V., Whıch We Apply Durıng Surgıcal Interventıon In Patıents Wıth Dıabetes Mellıtus Insulın Infusıon Method

Abstract

Treatment ol diabetic patient subjected to surgery with intermiltent infuslon of insulin in dexirose 79 patients with DM were subjected to surgery in the Department. of Endocrinology and Metabolic Discasts of Ankara University, Medical School. In 55 of the patients major surgery and in 24 minor surgery were carried-out. The modified, intermittend insulin infusion method of Oppenheimer, as we applied, is given in the text.The mortality rate in this group of diabetics was 5 96, Hypoglycemia due to il-regulation of metabolic condition, was observed in one case.

Keywords

• Diabetes and surgery
• Insulin therapy
• Perioperative complications

References

1. 1 - Aarima, M. et al. Glucose tolerance and insülin response during and after elective skeletal surgery. Ann. Surg. 179 : 926-935, 1974
2. 2 - Clare, FRCS,R. G. Some aspecis of carbonhydrate metabolism following surgery. Proc. R. Soc. Med. 67 : 831-840, 1974
3. 3 - Duncan, G.G, Diseases of metabolism. Saunders Co. Philadelphia 1965 s : 921-930
4. 4 - Fletcher, T. et al: Effect of 'surgery on blood sugar levels in diabetes mellitus. Lancet 2:52-70, 1965
5. 5 - Forsham, P.H. Management of diabetes during stress and surgery. İn Williams R.H.(ed.) Diabetes. New York, 1960
6. 6 - Galoway, J.A., Shuman, C. R. Diabetes and surgery. Amer. J. Med. 34: 177 - 185, 1963
7. 7- Gavin, J.R. et al. İnsülin dependent regulatıon of insülin receptor concentratıons. A.direct demonstratıon in cell culture. Proc. Nat. Acad. Sci. 71 : 84--100, 1974
8. 8 - Giddings. A.E.B. The control of plasma glucose in the surgical patient. Brit. J. Surg. 6l : 787-800, 1974

9. 8 - Hatemi, H. Diabet ve Cerrahi. Haseki Tıp Bülteni. 10 : 268 - 280, 1972
10. 9 - Kahn, O.ctal.: Mortality of diabetic patients treated surgically for lower limb infecton and/or gangrene. Diabeles. 23 : 287-300, 1974
11. 10 - Me Kittrick J.B. Surgical procedures. Diabetes Mellitus, diagnosis and treatment (ADA) 1: 145-150, 1964
12. 11 - Oppenheimer, H.E. Treatment in relation to surgery. Diabetes mellitus, diagnosis and ireatmeni (ADA), 1 : 151-161, 1964
13. 12 - Shuman, C.R, Management of diabetes mellitus in patients undergöing sürgery. TAMA 155, 62 - 70, 1954
14. 13 - Somogy, M. and Goldwasser, FLV. Ouantitative relatıonship between insülin and amount of carbohydrates utilized in diabetic persons. Amer. J. Med. 26 : 165-175, 1959
15. 14 - Stone, D.B. Surgery in the dinbetiç patient. Diabetes Mellitus, dingnosis and treatment (ADA), 2 : 176 - 187, 1967
16. 15 - Şaşmaz, D.C. Diabetes mellitus ve cerrahi. İ.Ü. Tıp Fak. Mec. 31 : 160-165, 1968
17. 16 - Yip. C.C, Preparatıon of “H insülin and its binding to liver plazma membrane in Friiz, J.B. (ed). İnsülin action. London, Academic press. p : 115-130, 1972