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胆囊切除附加Roux-en-Y胃肠转流术治疗2型糖尿病60例疗效分析 被引量:3
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作者 蔡斌 王治全 +4 位作者 代海鹏 李明超 王晓亮 付金坤 董朝妮 《陕西医学杂志》 CAS 2014年第7期879-881,共3页
目的:探讨胆囊结石治疗过程中对合并2型糖尿病(T2DM)外科治疗方法疗效。方法:对60例胆囊结石合并T2DM患者按照2∶1随机进行分组。治疗组(40例)采用开腹胆囊切除,附加Roux-en-Y攀80cm长度的胃肠转流术,对照组(20例)只做胆囊切除,术后给... 目的:探讨胆囊结石治疗过程中对合并2型糖尿病(T2DM)外科治疗方法疗效。方法:对60例胆囊结石合并T2DM患者按照2∶1随机进行分组。治疗组(40例)采用开腹胆囊切除,附加Roux-en-Y攀80cm长度的胃肠转流术,对照组(20例)只做胆囊切除,术后给予药物或胰岛素治疗2型糖尿病。两组进行长期随访观察。对手术前后空腹血糖(FBG)、餐后血糖(PBG)、空腹胰岛素水平(FINS)、胰岛素功能指数(HOMA-IR)、糖化血红蛋白(HbA1c)、体质指数(BMI)变化及术后2年糖尿病转归情况作为监测指标。结果:对照组20例胆囊结石手术治愈,治疗组40例合并T2DM病人,采用胆囊切除+Roux-en-Y胃肠短路术后治愈;治疗组术后1个月血糖呈持续稳定下降趋势;术后胰岛素功能指数改善,HbA1c亦出现明显下降。对照组无变化,仍需要药物或胰岛素来维持血糖稳定。结论:单纯的胆囊结石手术附加Roux-en-Y胃肠转流术治疗T2DM可达控制血糖效果,改善T2DM症状,具有一定临床意义。 展开更多
关键词 糖尿病 2型 外科学 吻合 Roux-en-Y 方法 胆囊切除 @胃肠转流术
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The effect of Shen-Fu on gastrointestinal tract injury and its potential mechanism during cardio-pulmonary bypass in patients undergoing cardiac surgery 被引量:7
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作者 夏中元 詹丽英 +1 位作者 何宇红 刘先义 《Chinese Journal of Traumatology》 CAS 2003年第4期245-248,共4页
Objective: To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism.Methods: Thirty-eight patients undergoing elective open heart surgery were assigned to Group ... Objective: To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism.Methods: Thirty-eight patients undergoing elective open heart surgery were assigned to Group C (control group, n = 18) and Group SF (n = 20) randomly. In Group SF, the patients received intravenous injection of SF (0.5 ml/kg) at the beginning of the surgery followed by a continuous infusion of 100 ml SF (1.0 ml/kg) solution diluted by saline at a rate of 0.004 ml · Kg-1 · min-1 with a Grasby pump. The control group was injected with normal saline in the same volume. Gastric intramucosal pH (pHi), activity of blood diamine oxidase ( DAO ), and concentrations of blood LPS and IL-6 were measured before CPB ( S0) and 1 h ( S1 ) and 2 h ( S2) after aortic declamping, respectively.Results: In Group C, pHi value was significantly lower at S1 and S2 than at S0 ( mean P <0.01) and blood DAO and concentrations of LPS and IL-6 were significantly higher at S1 and S2 than at S0 ( meanP < 0.01). In Group SF, pHi was obviously lower at S1 and S2 than at S0(P< 0.05) but LPS and IL-6 levels and DAO were higher at S, (mean P<0.05). Blood DAO and LPS level demonstrated significant negative correlations with pHi ( mean P < 0.01) while LPS concentration showed a positive correlation with blood DAO (P < 0.01) and IL-6 concentration (P < 0.05). At S1 and S2 after aortic declamping, the levels of pHi were higher in Group SF than in Group C (mean P <0.01 ) but DAO and LPS and IL-6 levels were significantly lower in Group SF than in Group C ( P <0.01).Conclusions: SF has a protective effect on gastrointestinal tract and can reduce inflammatory actions. 展开更多
关键词 Gastrointestinal tract Wounds and injuries Cardiopulmonary bypass Shen-Fu injection
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