胃癌合并2型糖尿病患者实施消化道重建术的血糖变化分析

Changing Analysis on the Blood Glucose Level of Patients with Gastric Cancer and Type 2 Diabetes Who Received Digestive Tract Reconstruction Operation

目的探讨不同消化道重建方式对胃癌合并2型糖尿病患者术后血糖的影响。方法回顾性分析某院2006年10月~2014年10月期间行根治性手术治疗30例胃癌合并2型糖尿病患者的临床资料,按照不同吻合方式将患者分为BillrothⅡ式组（9例）和Roux-en-Y组（21例）。统计并比较各组患者以下指标：（1）术前、术后1月、术后6月的空腹血糖（FBG）和餐后2小时（PG2h）血糖情况;（2）术前、术后6月的体重变化情况。采用SPSS11.5统计软件进行统计分析,手术前后各项指标的比较采用配对t检验。结果两组分别在术后1个月和术后6个月的FBG、PG2h水平均明显低于术前（P〈0.05）,但术后1个月和术后6个月的FBG、PG2h水平在组内比较差异不显著（P〉0.05）。术后6个月时两组间FBG水平及体重比较差异均显著（P〈0.05）。结论根据本组病例资料研究表明,采用Roux-en-Y或BillrothⅡ式吻合均可明显降低胃癌合并2型糖尿病患者的术后血糖水平,并且Roux-en-Y式吻合在控制术后血糖和体重方面相对具有一定的优势。

Objective To investigate the effects on postoperative blood glucose level of patients with gastric cancer and type 2 diabetes who received different forms of digestive tract reconstruction operation. Methods The clinical data of 30 cases of gastric cancer with type 2 diabetes treated radical surgery in our hospital from October 2006 to October 2014 were analyzed retrospectivcely. The patients were divided into two groups according to the different anastomotic methods： Billroth Ⅱ anastomosis group （n=9） and Roux-en-Y anastomosis group （n=21）. The indexes were analyzed and compared between two groups： （1） The levels of fast blood glucose （FBG） and 2 h postprandial blood glucose （PG2h） were detected before operation and on 1 month and 6 months postoperatively; （2） The body weight was measured before operation and 6 months postoperatively. Statistical analysis was performed with SPSS11.5, and all indexes were compared by the paired t-test. Results The FBG and PG2h levels in both groups detected postoperatively on 1 month and 6 months were significantly reduced than those before the operation respectively （P〈0. 05）, but the FBG and PG2h levels detected postoperatively on 1 month and 6 months were not statistically different in each group respectively （P〉0. 05）. The FBG levels and the body weight measured postoperatively on 6 months were statistically different between the two groups respectively （P〈0. 05）. Conclusions According to the clinical data in. our research, both Roux-en-Y anastomosis and Billroth Ⅱ anastomosis could decrease the level of postoperative blood glucose of gastric cancer patients with type 2 diabetes significantly, and Roux-en-Y anastomosis has its advantages in the controlling of postoperative blood glucose and body weight correspondingly.