糖尿病合并胃溃疡行腹腔镜胃穿孔修补术后应用恩格列净的控糖效果

Glucose Control Effect of Empagliflozin after Laparoscopic Gastric Perforation Repair for Diabetes Mellitus Complicated with Gastric Ulcer

目的探究行腹腔镜胃穿孔修补术的糖尿病合并胃溃疡患者术后接受恩格列净的控糖效果。方法回顾性选取2022年1月—2024年2月泉州市第一医院收治的80例接受腹腔镜胃穿孔修补术的糖尿病合并胃溃疡患者的临床资料,根据不同控糖方式分为对照组(n=40,胰岛素强化治疗)、研究组(n=40,恩格列净与胰岛素强化治疗联用),对比两组糖代谢水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、胰岛功能(胰岛素抵抗指数、胰岛β细胞功能指数)及临床疗效。结果治疗90 d后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。与对照组比较,研究组胰岛素抵抗指数更低、胰岛β细胞功能指数更高,差异有统计学意义(P均<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论接受腹腔镜胃穿孔修补术的合并胃溃疡的糖尿病患者在术后常规胰岛素强化治疗基础上加入恩格列净,可改善糖代谢水平及胰岛功能,提高临床疗效。

Objective To explore the glucose control effect of empagliflozin after laparoscopic gastric perforation re⁃pair in diabetic patients with gastric ulcer.Methods The clinical data of 80 patients with diabetes mellitus combined with gastric ulcer who underwent laparoscopic gastric perforation repair admitted to Quanzhou First Hospital from January 2022 to February 2024 were retrospectively selected.According to different glucose control methods,they were divided into control group(n=40,intensive insulin therapy)and study group(n=40,combination of empagliflozin and intensive insulin therapy).The levels of glucose metabolism(fasting blood glucose,2-hour postprandial blood glu⁃cose,glycated hemoglobin A1c),islet function(insulin resistance index,isletβcell function index)and clinical effi⁃cacy were compared between the two groups.Results After 90 days of treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose and glycated hemoglobin A1c in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).Compared with the control group,the insulin resis⁃tance index was lower and the isletβcell function index was higher in the study group,and the differences were statis⁃tically significant(both P<0.05).The total effective rate of treatment in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The addition of empagliflozin on the basis of routine intensive insulin therapy after laparoscopic gastric perforation repair in patients with diabetes mel⁃litus complicated with gastric ulcer can improve the level of glucose metabolism and islet function,and improve the clinical efficacy.