不同消化道重建方式对胃癌合并2型糖尿病患者血糖的影响

The Effect of Different Alimentary Reconstruction after Radical Surgery for Gastric Cancer on Blood Glucose in Patients with Type 2 Diabetes

目的:探讨胃癌手术不同消化道重建方式对合并2型糖尿病患者血糖变化的影响。方法:分析2006—2008年行根治性手术治疗的55例胃癌合并2型糖尿病患者术前及术后的血糖变化,按重建方式不同分为3组,包括行远端胃大部切除BillrothⅠ式吻合术11例,远端胃大部切除BillrothⅡ式吻合术25例,全胃切除食管空肠Roux-en-Y吻合术19例。比较3种术式患者术前、术后2周及半年空腹血糖和餐后2h血糖水平。结果:BillrothⅡ式吻合、Roux-en-Y吻合2组患者术后2周及术后半年的血糖水平与术前相比出现持续而稳定的下降,且均较BillrothⅠ式吻合术组下降明显(P<0.05)。BillrothⅡ式吻合组、Roux-en-Y吻合组术后半年血糖控制有效率分别为72.00%和73.68%,差异无统计学意义,但均高于BillrothⅠ式吻合组的27.27%。结论:BillrothⅡ吻合和Roux-en-Y吻合术对于合并2型糖尿病的胃癌患者具有一定的血糖控制作用。

Objective：To assess the effect of different alimentary reconstruction on blood glucose in gastric cancer patients complicated with type 2 diabetes. Methods：The retrograde analysis was made in 55 cases of gastric cancer with type 2 diabetes from 2006 to 2008. These patients were divided into three groups,distal gastrectomy with BillrothⅡanastomosis （n = 25）, total gastrectomy with esophagojejunum Roux-en-Y anastomosis （n = 19） and distal gastrectomy with BillrothⅠ anastomosis （n = 11）. The levels of fast blood glucose and 2 h postprandial blood glucose were detected in patients before,after 2 weeks and 6months operation in three groups. Results：Comparing to the third group, the level of blood glucose showed a steady and sustained descent in patients after 2 weeks and 6 months surgery in the other two groups （P 0.05）. The effective rates were 72.00% and 73.68% for the Billroth Ⅱ and Roux -en -Y groups respectively. However, there was no difference between them （P 0.05）. Conclusion：It is an effective method for blood glucose control using surgery of BillrothⅡ and Rouxen-Y anastomosis in gastric cancer patients with type 2 diabetes.