消化道不同重建方式对合并糖尿病胃癌患者术后血糖的影响  

Comparative Study of Diabetes Mellitus Resolution According to Reconstruction Type After Gastrectomy in Gastric Cancer Patients with Diabetes Mellitus

作　　者：李航[1] 江小杰[1] 吴黎敏[1] 

机构地区：[1]莆田学院附属医院肿瘤科,福建莆田351100

出　　处：《医学信息》2013年第1期84-85,共2页Journal of Medical Information

基　　金：福建省莆田市科技局项目（编号：2008S01（3-61）

摘　　要：目的 评价合并糖尿病的胃癌患者消化道不同重建方式对术后血糖的影响。方法回顾2008年1月-2（）11年12月我院手术治疗的合并2型糖尿病的胃癌患者73例，根据术中消化道重建方式不同将上述患者分为例组，采用BillrothI式吻合术32例为A组，采用Roux—en—Y吻合术41例为B组。观察所有患者术前、术后1个月、术后3个月、术后6个月、术后1a的空腹血糖（FBG）及餐后2h血糖（2hPG）的情况。结果73例患者均顺利完成胃癌根治术，并按常规时间出院，B组术后1个月、3个月、6个月及1a的FBG及2hPG均优于同时间点的A组（P〈0．05）；术后1aA组和B组血糖控制有效率分别为25．0％（8／32）和68．3％（28／41），差异有统计学意义（P〈0．05）。结论胃癌根治术可改善或缓解合并糖尿病患者术后的血糖情况．其中R．oux—en—Y消化道重建方式对于术后血糖控制的有效率较高。Objective This study was conducted to investigate diabetes mellitus （DM） resolution ＇after gastrectomy according to reconstruction type in gastric cancer patients. Methods Retrograde analyzing 73 cases of distal gastric cancer with DM from January＇, 2008 to December, 2011. These patients were divided in to two grnups： Roux-en-Y anastomoses in treatment group （n= 41）, Billroth I （BI） anastomoses in control group （ n= 32 ）. The levels of fasting blood glucose （FBG）and 2h postprandial blood glucose （2hPG）were detected before operation and after operation one month, three months, six months and one year in three groups. Results All 73 patients survived the operation amt no severe postoperative complications occuzTed. Comparing to the level before operation, the levels of FBG and 2hPG after operation one month, three months, six months and one year showed a descent in group Roux- en- Y （P 〈0.05 ）,and there was also more improvement than group Billroth I . The effec, t rates of blood glucose control after operation one year were 25.0% and 68.3% for group Billroth I and group Roux- en- Y respectively.And there was difference between the two groups （P 〈0.05）. Conclusion Many gastric cancer patients with DM who received a gastrectomy showed remission or improvement of DM. The Roux-en-Y anastomoses group had higher DM remission or improvement rate than the BI group.

关 键 词：胃癌 糖尿病缓解 消化道重建 

分 类 号：R587.1[医药卫生—内分泌]