全胃切除RYGBP手术治疗对糖尿病胃癌患者体质指数、血糖指标的影响

Effect of RYGBP Total Gastrectomy on Body Mass Index and Blood Glucose in Diabetic Gastric Cancer Patients

目的 分析全胃切除残胃不同容积Roux-en-Y胃旁路术(Roux-en-Y gastric bypass,RYGBP)治疗对糖尿病胃癌患者临床疗效、体质指数、血糖指标的影响。方法 回顾性分析2020年1月—2022年1月福建中医药大学附属人民医院收治的63例糖尿病胃癌患者的临床资料,按照治疗方法的不同将患者分为对照组(30例)、研究组(33例),对照组选择胃大部分切除的RYGBP手术治疗,研究组则选择全胃切除RYGBP手术治疗。观察比较两组治疗效果、体质指数及空腹血糖水平、2 h葡萄糖耐受量变化情况。结果 对照组、研究组的总有效率分别为76.67%、75.76%,差异无统计学意义(χ^(2)=0.007,P=0.933)。与术前相比,两组患者术后3个月的体质指数均明显降低,差异有统计学意义(P<0.05);而两组术后3个月的体质指数比较,差异无统计学意义(P>0.05)。与术前相比,两组患者术后3个月的空腹血糖水平、2 h葡萄糖耐受量水平均明显降低,差异有统计学意义(P<0.05);而两组患者术后3个月的各指标比较,差异无统计学意义(P>0.05)。结论 在对糖尿病胃癌患者进行治疗时,采用RYGBP手术治疗能取得显著的降糖效果,而不同的残胃容积并不会影响降糖效果。

Objective To analyze the effects of different volume Roux-en-Y gastric bypass(RYGBP)on the clinical efficacy,body mass index and blood glucose indexes of diabetic gastric cancer patients.Methods The clinical data of sixty-three patients with diabetic gastric cancer admitted to the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2020 to January 2022 were retrospectively analyzed.According to different treatment methods,all patients were divided into control group(30 cases)and study group(33 cases).The control group underwent RYGBP surgery with partial gastrectomy,while the study group underwent RYGBP surgery with complete gastrectomy.The therapeutic effect,body mass index,fasting blood glucose level and 2 h glucose tolerance were observed and compared between two groups.Results The total effective rates of the control group and the study group were 76.67%and 75.76%,respectively,and the difference was not statistically significant(χ^(2)=0.007,P=0.933).Compared with before surgery,the body mass index of both groups was significantly decreased at 3 months after surgery,the difference was statistically significant(P<0.05).There was no significant difference in body mass index 3 months after surgery between the two groups(P>0.05).Compared with before surgery,fasting blood glucose level and 2 h glucose tolerance level were significantly decreased in both groups 3 months after surgery,the difference was statistically significant(P<0.05).There was no statistically significant difference in the indexes 3 months after operation between the two groups(P>0.05).Conclusion In the treatment of diabetic gastric cancer patients,RYGBP surgery can achieve significant hypoglycemic effect,while different residual stomach volume does not affect the hypoglycemic effect.