胃大部切除术后Roux-en-Y吻合对非肥胖2型糖尿病的临床疗效观察

Therapeutic effect of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on type 2 diabetes mellitus in non-obese patients

目的评价胃大部切除术后Roux-en-Y吻合对非肥胖2型糖尿病患者的临床疗效。方法回顾性分析我院2005年1月-2010年1月收治的16例因为胃癌或胃溃疡接受Roux-en-Y胃肠转流术,且不合并肥胖的糖尿病患者的临床资料。结果所有患者随访6个月,空腹血糖、餐后2 h血糖、糖化血红蛋白较术前下降（P〈0.05）。8例病人不需要药物和饮食控制达到糖尿病治愈标准（50%）,5例病人治疗药物较前减少,糖尿病明显改善（31.25%）,总体有效率81.25%。结论 Roux-en-Y胃肠转流术可以改善非肥胖2型糖尿病患者的糖尿病症状,为糖尿病的治疗提供了一种新的手段。

Objective To evaluate the therapeutic effect of Roux-en-Y anastomosis following subtotal gastrectomy on type 2 diabetes mellitus（T2DM） in non-obese patients.Methods We performed a retrospective analysis of 16 non-obese patients with T2DM undergoing Roux-en-Y anastomosis following subtotal gastrectomy for stomach cancer and upper gastrointestinal tract ulcer.Results All the patients were followed up for 6 months after the surgery.Roux-en-Y gastrojejunostomy significantly lowered the levels of fasting plasma glucose（FPG）,2 h postprandial plasma glucose（2hPG）,and glycated hemoglobin（HbA1c）（P0.05）.Of these patients,8（50%） achieved adequate glycemic control without antidiabetic medication and 5（31.25%） showed obvious improvement.The total effectiveness rate of the surgery was 81.25%.Conclusion Roux-en-Y gastrectomy can effectively ameliorate the diabetic symptoms and might serve as a new treatment option for T2DM in non-obese patients.