胃切除术对胃癌伴2型糖尿病患者血糖改善的疗效观察

Efficacy of gastrectomy in improvement of blood sugar in patients suffering from gastric cancer with type 2 diabetes

目的观察不同胃切除术对胃癌伴T2DM患者术后的血糖改善情况。方法回顾性分析36例胃癌伴T2DM患者,根据其接受手术方式不同将研究对象分为三组。PG组患者行近端胃切除食管残胃吻合术;BI组患者行远端胃切除BillrothⅠ吻合术;RY组患者行全胃切除Roux-en-Y吻合术。收集所有患者术前、术后1、3、6月空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、应用抗2型糖尿病药物情况等资料。术后6月根据患者FBG、Hb A1c、应用抗2型糖尿病药物情况来评价血糖改善情况。结果 RY组中T2DM治疗有效率80.00%,而PG组为20.00%、BI组为18.20%。RY组与PG、BI组比较,治疗T2DM疗效差异有统计学意义(P<0.05)。结论全胃切除Roux-en-Y吻合术可有效改善胃癌伴T2DM患者的血糖水平。

Objective To compare the efficacy of different gastrectomies for improving the blood sugar levels in patients suffering from gastric cancer with type 2 diabetes. Methods The retrospective analysis was made in 36 cases suffering from gastric cancer with type 2 diabetes and undergoing gastrectomy. The patients were divided into 3 groups according to different gastrectomy： proximal gastrectomy remnant gastric esophageal anastomosis （PG） group （ n = 10）, Billroth I distal gastrectomy with gastroduodenal anastomosis （BI） group（ n = 11 ） ,total gastrectomy Roux-en-Y-anastomosis（RY） group（ n = 15 ）. The levels of FBG, HbAlc and anti-diabetic drugs were detected before surgery and after surgery for 1,3, 6 months in all cases to evaluate the improvement of blood sugar. Results The effective rate of gastrectomy for type 2 diabetes was 80.0% in RY group,20.0% in PG group and 18.20% in BI group, and there was statistical difference among these groups（P 〈0.05 ）. Conclusion Total gastric resection Roux-en-Y anastomosis can effectively relieve the level of blood glucose in patients suffering from gastric cancer with type 2 diabetes.