不同残胃容积胃旁路术对胃癌合并非肥胖型2型糖尿病患者降糖效果的影响  

Clinical Study of the Effect of Gastric Bypass with Different Residual Stomach Volume on Non-Obese Patients with Type 2 Diabetes Mellitus

作　　者：林克荣[1] 刘斌 黄盛 王畅 王俊杰 喻敏 王瑜 

机构地区：[1]南京军区福州总医院普外消化病中心,福建省福州市350025 [2]普通外科研究所

出　　处：《中国全科医学》2012年第12期1356-1359,共4页Chinese General Practice

基　　金：福建省重点科技计划项目(2009Y0039);南京军区医药卫生科研重点专项(09Z031)

摘　　要：目的探讨不同残胃容积的Roux-en-Y胃旁路术(RYGBP)对胃癌合并非肥胖型2型糖尿病(T2DM)患者降糖效果的影响。方法回顾性分析2007年6月—2009年12月我科收治的77例胃癌合并非肥胖型T2DM患者,其中37例行全胃切除RYGBD,40例行胃大部切除RYGBD。比较术前(0月)和术后1、3、6、12个月两组患者体质指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平变化及术后12个月的手术疗效。结果与术前相比,两组患者术后的BMI及FPG、HbA1c水平均显著下降(P<0.05);术后同一时间点组间比较差异无统计学意义(P>0.05)。术后12个月两组患者手术疗效比较差异无统计学意义(P>0.05)。结论不同残胃容积的RYG-BP均可有效改善胃癌合并非肥胖型T2DM患者的血糖,且残胃容积大小并不影响RYGBP对此类患者的降糖效果。Objective To evaluate the effect of Roux - en - Y gastric bypass with different residual stomach volume on non - obese patients with type 2 diabetes mellitus. Methods From June 2007 to December 2009, 77 non - obese patients with type 2 diabetes mellitus and gastric lesions underwent Roux - en - Y gastric bypass with total gastrectomy （ n = 37 ） or subtotal gastrectomy （n =40） in the department of general surgery. Patients were observed for twelve months after surgery. The body mass index, the fasting blood glucose and the glycosylated haemoglobin concentrations were retrospectively analyzed before surgery （0 month） and 1, 3, 6, 12 months after surgery, and the efficiency of the surgery was analyzed 12 months after surgery. Results The body mass index, fasting blood glucose and glycosylated haemoglobin concentrations in the two groups were both significantly decreased after surgery （ P 〈 0.05 ） . However, no significant differences were found between the two groups at the same time （ P 〉 0. 05 ） . As to the efficiency of the surgery after 12 month, there were also no significant differences between the group of Roux - en - Y gastric bypass with total gastrectomy and the group of Roux - en - Y gastric bypass with subtotal gastrectomy （ p 〉 0. 05 ） ~ Conclusion Roux - en - Y gastric bypass surgery can effectively improve glucose metabolism in type 2 diabetic patients, and the therapeutic effect of gastric bypass has no obvious relation to the size of residual stomach volume.

关 键 词：胃旁路术 糖尿病 2型 糖化血红蛋白 血糖 胃容积 

分 类 号：R587.1[医药卫生—内分泌]