全胃切除消化道重建术对胃癌合并Ⅱ型糖尿病血糖的影响

Total gastrectomy reconstruction procedures on blood sugar of gastric cancer concomitance T2DM

目的研究全胃切除加消化道重建术对胃癌合并Ⅱ型糖尿病(T2DM)术后血糖的影响。方法将胃底贲门癌合并T2DM患者25例行全胃切除加Roux-Y吻合术(A组);选取同期的远端胃癌合并T2DM患者25例行毕Ⅱ式手术(B组)作为对照组;比较两组术后第一个月及半年的血糖、C肽、糖化血红蛋白变化,采用t检验。结果①A组手术前后血糖、糖化血红蛋白及C肽改善无显著性差异(P>0.05),B组手术前后血糖、糖化血红蛋白及C肽的变化有显著性差异(P<0.05)。②两组间术后对比差异有显著性(P<0.05)。结论①全胃切除加Roux-Y吻合术对术后近期血糖无明显影响。②毕Ⅱ式术后近期血糖有明显改善,该术式对糖尿病有治疗作用。③胃与术后糖尿病改善有密切关系。④迷走神经肝支可能影响肠-胰岛轴。

Objective To explore the effect of total gastrectomy adding reconstruction procedures on blood sugar of gastric cancer concomitance T2DM.Methods 25 cases were operated total gastrectomy and Roux-Y on gastric bottom and cardia cancer consolidation type 2 diabetes mellitus（A group）,at the same time,25 cases gastric sinuses cancer were performed Billroth II（B group）,to be collating group.To compare preoperative and postoperative the blood sugar,HbA1c and C peptide among A and B,using t test to analyze.Results 1.The difference was no significant that A group preoperative and postoperative the biood sugar,HbA1c and C peptide.The difference was significant that B group preoperative and postoperative the blood sugar,HbA1c and C peptide.2.The postoperative difference was significant among A group and B.Conclusion The operation total gastrectomy adding Roux-Y don＇t evidently produce an effect on postoperative blood sugar in the near future.The operation Billroth II do evidently affect on postoperative blood sugar in the near future,it show that the operation can treat T2DM.3.The relation of stomach and postoperative T2DM improving is affinity.4. The liver branch of pneumogastric nerve vagus can affect on entero-insular axis.