胃大部切除胃空肠Roux-en-Y吻合术治疗胃癌合并2型糖尿病的临床观察  

Effects of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on patients with gastric carcinoma and type 2 diabetes mellitus

作　　者：吴学队 康海立 沈静侠 王东江 崔庆贵 

机构地区：[1]河北省迁安市人民医院肿瘤外科,迁安064400

出　　处：《中国肿瘤临床与康复》2015年第6期653-655,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨胃大部切除胃空肠Roux-en-Y吻合术在胃癌合并2型糖尿病(T2DM)患者中的血糖改善效果。方法选取21例胃癌合并T2DM的患者,均采用胃大部切除胃空肠Roux-en-Y吻合术治疗,回顾性分析其临床资料,对血糖改善情况进行评价,平均随访时间为26.6个月。结果全组患者的身体质量指数(BMI)<30,术后空腹血糖、餐后2 h血糖以及糖化血红蛋白含量(Hb A1c)均较术前改善(P<0.05),其中血糖水平得到充分控制(Hb A1c<7%),且不需降糖药物治疗的患者12例(57.1%),血糖水平明显改善的患者5例(23.8%),术后T2DM总有效率为81.0%。结论BMI<30的胃癌伴T2DM的患者采用胃大部切除胃空肠Roux-en-Y吻合术治疗,血糖改善效果较好,但还需要长期随访和扩大样本量研究。Objective To investigate the effects of subtotal gastrectomy and Roux-en-Y gastrojeju- nostomy on patients with gastric carcinoma and type 2 diabetes mellitus （T2DM）. Methods 21 patients with gastric carcinoma and T2DM were treated with subtotal gastrectomy and Roux-en-Y gastrojejunostomy, and the clinical effects were analyzed with a mean postoperative follow-up period of 26. 6 months. Results All of the patients had a body mass index （BMI） 〈 30. The levels of fasting plasma glucose （FPG）, 2h postprandial plasma glucose （2hPG） and glycated hemoglobin （HbA1c） were decreased significantly after surgery（ P 〈 0.05 ）. Overall, 12 patients （ 57. 1% ） achieved adequate glycemic control （ HbA1 c 〈 7% ） without antidiabetic medication,and 5 patients（23.8% ） had important improvement. Total effective rate for T2DM after the operation was 81.0%. Conclusion Subtotal gastrectomy and Roux-en-Y gastrojejunostomy seem to be an effective operation in controlling T2DM in the patients with BM1 〈 30. Studies with longer fol- low-up and a larger number of patients are necessary to better define the role of this procedure.

关 键 词：胃肿瘤 2型糖尿病 胃大部切除 ROUX-EN-Y胃空肠吻合术 

分 类 号：R735.2[医药卫生—肿瘤]