根治性胃癌切除术中不同吻合术式对胃癌合并2型糖尿病患者术后血糖的影响  

The Effect of Different Anastomosis on Blood Glucose after Radical Surgery for Patients with Gastric Cancer complicated with Type 2 Diabetes

作　　者：周祥[1] 熊竹娟[2] 唐令超[1] 赵平[1] 丁志[1] 肖硕萌[1] 陈小东[1] 唐晓丽[1] 周进[2] 

机构地区：[1]四川省肿瘤医院胃肠外科,成都610041 [2]四川省肿瘤医院肿瘤内科,成都610041

出　　处：《肿瘤预防与治疗》2015年第4期200-203,共4页Journal of Cancer Control And Treatment

摘　　要：目的:探讨根治性远侧胃切除术中不同的吻合方式对胃癌合并2型糖尿病患者术后血糖的影响。方法:回顾我院64例胃癌合并2型糖尿病患者,行根治性远侧胃切除术,按吻合方式不同,分为3组,毕Ⅰ式吻合22例(A组),毕Ⅱ式+空肠侧侧吻合20例(B组),Roux-en-Y吻合22例(C组),分析比较此3组患者术前术后空腹血糖变化及糖尿病控制情况。结果:3组患者术后空腹血糖均有下降,且术前术后比较差异有统计学意义(P<0.05),同A组相比,B组、C组术后1周、术后1月、术后6月空腹血糖均有下降,差异有统计学意义(P<0.05)。与A组相比,B组和C组中糖尿病治愈例数较多,而无效例数较少,差异有统计学意义(P<0.05)。结论:毕Ⅱ式+空肠侧侧吻合、残胃空肠Roux-en-Y吻合方式可能改善2型糖尿病患者的空腹血糖水平,可成为该类患者的首选吻合方式。Objective： To study the effect of different anastomosis on blood glucose after radical surgery for patients with gastric cancer complicated with type 2 diabetes. Methods： Data of 64 cases of gastric cancer complicated with type 2 diabetes in our hospital were retrospectively analyzed. All patients accepted most radical distal gastric resection and were divided into 3 groups depending on the different way of digestive tract reconstruction： group A,Billroth I（ 22 cases）,group B,Billroth II type ＋ jejunum side to side（ 20 cases）,group C,Roux-en-Y（ 22 cases）. The fasting plasma glucose（ FPG） and the control status of diabetes pre-and post-operation were analyzed and compared. Results： FPG decreased significantly in all patients after operation（ P〈0. 05）. Compared with group A,FPG of group B and group C decreased significantly 1 week,1 month and 6 months after operation（ P〈0. 05）. Compared with group A,group B and group C had higher curative rate of diabetes mellitus with statistically significant difference（ P〈0. 05）. Conclusion： Billroth II type＋ jejunum side to side anastomosis,residual stomach and jejunum Roux-en-Y anastomosis may effectively control the PFG in patients with type 2 diabetes mellitus. They are recommended for the preferred choices for the treatment of patients with gastric cancer complicated with type 2 diabetes.

关 键 词：胃癌 2型糖尿病 残胃与肠道吻合方式 

分 类 号：R735.2[医药卫生—肿瘤]