影响胃转流术治疗2型糖尿病效果的因素研究

Research on effect factors of gastric bypass surgery in treatment of type 2 diabetes mellitus

目的:总结胃转流术治疗2型糖尿病疗效的影响因素,并探讨其手术适应证。方法:回顾分析为32例2型糖尿病患者行胃转流术的临床资料,对比手术前、后相关指标的变化情况。结果:胃转流术后12个月9例完全缓解,23例未缓解,术后无严重并发症发生。完全缓解组患者年龄、病史、术前空腹血糖、餐后2小时血糖、糖化血红蛋白(hemoglobin A1c,HbA1c)均小于未缓解组,差异有统计学意义(P<0.05);两组患者性别组成、BMI差异无统计学意义(P>0.05)。开腹组与腹腔镜组患者年龄、病史、术前空腹血糖、餐后2 h血糖、HbA1c、术后12个月降糖效果差异均无统计学意义(P>0.05)。结论:2型糖尿病患者术前年龄、病史、血糖控制情况及术中剩余胃囊的大小明显影响胃转流术后降糖效果。

Objective：To summarize the effect factors of gastric bypass surgery in treatment of type 2 diabetes mellitus,and explore the surgical indications.Methods：Clinical data of type 2 diabetes patients（n=32） who underwent gastric bypass were retrospectively analyzed and the preoperative and postoperative related index changes were compared.Results：Nine cases were completely remitted and 23 cases were not remitted by the end of 12 months after gastric bypass and postoperative complications were not severe.Preoperative age,medical history,fasting plasma glucose（FPG）,2h plasma glucose（PG）,hemoglobin A1c（HbA1c） of complete remission group were lower than those of non-remission group,and differences were statistically significant（P〈0.05）.There were no statistically significant differences between the complete remission group and the non-remission group in gender and preoperative BMI（P〉0.05）.There were no statistically significant differences between the open group and the laparoscopic group in preoperative age,gender,medical history,FPG,2h PG,HbA1c and postoperative result after 12 months（P〉0.05）.Conclusions：Postoperative result is significantly effected by preoperative age,medical history,controlled levels of blood glucose and intraoperative volume of residual gastric pouch in patients with type 2 diabetes mellitus.