不同消化道重建方式对胃癌合并2型糖尿病患者血糖的影响

The Effect on Blood Glucose of Different Gastrointestinal Reconstruction after Radical Surgery for Gastric Cancer Patients with Type-2 Diabetes Mellitus

目的探讨胃癌合并2型糖尿病患者行不同消化道重建手术方式对血糖的影响。方法回顾性分析我院2010年1月～2012年12月收治的53例远端胃癌合并2型糖尿病患者的临床资料,根据消化道重建方式分为两组：Ⅰ组25例,采用BillrothⅠ式手术行消化道重建;Ⅱ组28例,采用BillrothⅡ式手术行消化道重建。比较两组术后血糖的变化及疗效。结果Ⅰ组术后空腹血糖（FBG）、OGTT 2h血糖（2h PBG）、糖化血红蛋白（Hb A1c）及空腹C肽与术前比较均无明显变化（均P〉0.05）,Ⅱ组术后FBG、2h PBG及Hb A1c较术前明显降低（均P〈0.05）,空腹C肽较术前明显升高（P〈0.05）。两组患者术后FBG、2h PBG、Hb A1c及空腹C肽等指标比较均具有统计学差异（均P〈0.05）。Ⅰ组临床有效率为20%,Ⅱ组为92.9%,组间比较差异具有统计学意义（χ2=28.876,P〈0.01）。结论 BillrothⅡ式消化道重建方式对于胃癌合并2型糖尿病患者具有一定的血糖控制作用。

Objective To explore the effect on blood glucose of different alimentary reconstruction after radical surgery for gastric cancer patients with type-2 diabetes mellitus （T2DM）. Methods The clinical data of 53 gastric cancer patients with T2DM admitted from January 2010 to December 2012 were analyzed retrospec- tively. They were divided into two groups according to different types of alimentary reconstruction： group Ⅰ were performed BillrothⅠ （n = 25, ）, and group Ⅱ were carried out Billroth Ⅱ （n = 28）. Results There was no statistical difference in FBG, 2h PBG, HbAle and peptide C before and 6 months after surgery in group Ⅰ （P 〉0.05）. The FBG, 2h PBG and HbAle were decreased, and the peptide C was increased 6 months af- ter operation than those before the operation in group Ⅱ （ P 〈 0.05 ）. There were statistic differences in all the laboratory indexes between two groups after the surgery （ P 〈 0.05 ）. The clinical effective rate was 20% in group Ⅰ and 92.9% in group Ⅱ, and there was statistic difference between two groups （X2 = 28. 876, P 〈 0.01 ）. Conclusion The reconstructive surgery of Billroth Ⅱ anastomosis is an effective control method of blood glu- cose for gastric cancer patients with T2DM.