糖尿病患者の回腸導管症例の検討

MANAGEMENT OF DIABETIC PATIENTS FOR ILEAL CONDUIT URINARY DIVERSION

緒言

　高齢者に対し手術を行なう機会の多い泌尿器科領域では原疾患のほかに種々な合併症を有した患者に出会うことが多い。今回著者らは合併症として糖尿病を伴つた膀胱腫瘍の2例と原発性女子尿道癌の1例に膀胱全摘除，膀胱尿道全摘除と尿路変更として回腸導管を造設し，術後の非経口摂取期間を含め，糖尿病患者の術前術後の管理につき検討したので若干の文献的考察を加え報告する。

Two patients with bladder tumor and a patient with urethral carcinoma who had diabetes mellitus underwent total cystectomy and total cysturethrectomy with ileal conduit urinay diversion.

They were put in good nutritional balance, well controlled diabetic status with good hydration and electrolyte balance at the time of opration.

Adequate amounts of carbohydrate and necessary amounts of insulin to promote utilization of these carbohydrate were given to those patients postoperatively to prevent ketoacidosis and hypoglycemia.