2型糖尿病胃肠转流术后早期肠内营养对血糖的影响

The Effect of Early Enteral Nutrion on Blood Glucose in Type 2 Diabetes Patients after RYGBP

目的:探讨2型糖尿病Roux-en-Y胃肠转流术(RYGBP)后早期肠内营养对患者血糖的影响。方法:回顾2011年7月至2012年7月我科63例不同发病年龄、不同病程的2型糖尿病患者行Roux-en-Y胃肠转流术(RYGBP)后的恢复情况。共分两组:A组为术后完全肠外营养直至胃肠道功能恢复正常的患者;B组为术后早期开始肠内营养患者。监测两组患者术后3天至2周的血清白蛋白含量、血脂、肠蠕动恢复时间、血糖水平、C肽水平。结果:A、B两组术后血清白蛋白含量及血脂水平无显著性差异。B组患者肠功能恢复时间少于A组,血糖水平下降时间较A组快,其血糖下降时间与肠功能恢复时间一致,B组血清C肽水平变化时间较A组提前。结论:2型糖尿病胃肠转流术(RYGBP)后早期肠内营养支持可以促进肠道功能恢复,加快血糖水平下降,改善胰岛调节功能。

Objective： To investigate the effect of early enteral nutrion on blood glucose in type 2 diabetes patients who accepted the surgery of Roux-en-Y gastrointestinal bypass postoperative（RYGBP）. Method： To review the recovery of 63 patients with type 2 diabetes after they received the surgery of RYGBP, from july 2011-july 2012. All patients were divided into two groups： patients in Group A were given total parenteral nutrion until their gastrointestinal funtion recoveied normal; Patients in Group B were given early enteral nutrion. And the level of serum albumin and blood lipids, peristalsis recovery time, the level of blood glucose and C-peptide were detected. Result： The level of serum albumin and blood lipids had no significent difference in group A and group B. The peristalsis recovery time of group B was less than group A, and the level of blood glucose of group B drop faster than that in group A. The time of blood glucose dropped keep consistent with the time of peristalsis recovery. The time of C-peptide change in group B was ahead of group A. Conclusion： Early enteral nutrion after RYGBP in patients with type 2 diabetes can promote recovery of intestinal function, accelerate the decline of glucose level, and improve the adjustment function of islet.