Roux-en-Y吻合重建对胃癌合并糖尿病患者血胰岛功能的影响  

The influence of Roux-en-Y anastomosis on islet function in gastric cancer patients combined with diabetes

作　　者：乔文辉[1] 杨磊[1] 李斌[1] 柴琛[1] 

机构地区：[1]兰州大学第一医院普外一科,730000

出　　处：《中国糖尿病杂志》2016年第1期50-52,共3页Chinese Journal of Diabetes

基　　金：甘肃省中医药科技技术研究课题(GZK-2011-62)

摘　　要：目的探讨Roux-en-Y吻合重建对胃癌合并T2DM患者血糖水平、胰岛功能及并发症的影响。方法根据手术方式将120例Ⅰ~Ⅱ期胃癌合并T2DM患者随机分为观察组62例及对照组58例,对照组行胃食管吻合术,观察组行Roux-en-Y吻合重建术,比较两组治疗前后血糖及胰岛素的变化。结果术后6个月,观察组BMI[（23.36±2.44）vs（25.33±2.92）kg/m2]、FPG[（5.58±2.02）vs（8.96±1.75）mmol/L]、2hPG[（10.36±3.22）vs（13.82±2.77）mmol/L]、HbA1c[（4.28±1.36）%vs（9.22±1.25）%]、HOMA-IR[（2.12±0.85）vs（4.02±1.22）mIU/L]、HOMA-β[（3.89±0.82）vs（4.58±0.79）mmol/L]均低于对照组（P〈0.05）。观察组术后6个月FIns[（14.28±1.33）vs（10.78±2.36）mIU/L]、FC-P[（3.98±1.02）vs（1.39±0.45）μg/L]、2hIns[（38.12±3.98）vs（33.28±4.15）mIU/L]、2hC-P[（9.86±2.12）vs（5.18±1.52）μg/L]较术前升高（P〈0.05）。观察组近期并发症发生率和远期并发症发生率均低于对照组[3.22%vs 17.20%;4.84%vs 18.96%,P〈0.05]。结论 Roux-en-Y吻合术能有效改善胃癌合并T2DM患者胰岛β细胞功能,降低血糖水平,术后并发症发生率低,安全有效。Objective To investigate the effects of Roux-en-Y anastomosis on blood sugar, islet function and complications in patients with gastric cancer and T2DM. Methods 120 hospitalized patients with gastric cancer （ Ⅰ-Ⅱ ） and T2DM were recruited and divided into observation group （n= 62） and control group （n=58）. Patients in control group underwent gastro-esophageal anastomosis, and patients in observation group underwent Roux-en-Y anastomosis reconstruction. The changes of blood sugar and insulin before and 6 months after surgery between two groups were compared. Results Compared with control group at 6 months after surgery, patients in observation group had lower BMI [ （23.36 ± 2.44） vs （25.334-2.92） kg/m2],FPG[（5.58±2.02） vs （8.96±].75） mmol/L],2 hPG[（10. 36 ± 3. 22） w O3.82±2.77） mmol/L], HbAlc[（4. 28± 1.36）% vs （9.22± 1.25）m], HOMA-IR[（2.12±0. 85） vs （4. 02±1.23）] and HOMA β[（3.89±0.82） vs （4.58±0.79）]（all P〈0.05）. In observation group,the levels of Fins[（14.28±1.33） vs （10.78±2.36） mlU/L] ,FC-P[（3. 98±1. 02） vs （1.39±0. 45） μg/L], 2 hIns[（38.12±3. 98） vs （33.28±4.15） mIU/L] and 2 hC-P[（9.86±2.12） vs （5.18±1.52） μg/L] were higher after surgery 6 months than before treatment（all P〈0. 05）. Both recent and long-term complication incidence were lower in observation group than that in control group [3. 220/oo vs 17.20%; 4.84% vs 18.96%,P〈0.05]. Conclusion Roux-en-Y gastric anastomosis can improve islet function in gastric cancer patients with T2DM and reduce the incidence of postoperative complications.

关 键 词：胃癌 糖尿病 血糖 胰岛功能 

分 类 号：R735.2[医药卫生—肿瘤] R587.1[医药卫生—临床医学]