天津医药

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胃癌手术消化道重建方式对2型糖尿病患者血糖影响

李川1,戚峰1,刘彤2   

  1. 1. 天津医科大学总医院
    2. 天津医科大学普通外科
  • 收稿日期:2010-04-21 修回日期:2010-04-24 出版日期:2010-06-15 发布日期:2010-06-15
  • 通讯作者: 李川

The Effect on Blood Glucose by Different Alimentary Reconstruction following Radical Surgery on Gastric Cancer Patients with Type 2 Diabetes

  • Received:2010-04-21 Revised:2010-04-24 Published:2010-06-15 Online:2010-06-15

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摘要： 目的: 探讨胃癌手术不同消化道重建方式对合并2型糖尿病患者血糖变化的影响。 方法：回顾性分析2006年至2008年根治性手术治疗的55例胃癌合并2型糖尿病患者术前及术后的血糖变化，按重建方式不同分为3组，包括11例行远端胃大部切除BillrothⅠ式吻合术；25例行远端胃大部切除BillrothⅡ式吻合术；19例行全胃切除食管空肠Roux-en-Y吻合术。 结果：BillrothⅡ式吻合、Roux-en-Y吻合两组患者术后两周及术后半年的血糖水平与术前相比出现持续而稳定的下降，且均较BillrothⅠ式吻合术组下降显著(P< 0.05)。而前面两种术式之间对血糖的控制效果差异无统计学意义 (P>0.05)，术后半年血糖控制有效率分别为72.00%和73.68%。 结论：BillrothⅡ吻合和Roux-en-Y吻合术对于合并有2型糖尿病的胃癌患者具有一定的血糖控制作用。

关键词: 胃癌, 2型糖尿病, BillrothⅠ式吻合术, BillrothⅡ式吻合术, Roux-en-Y吻合术

Abstract: Objective：To assess the effect of different alimentary reconstruction on glucose in gastric cancer patients complicated with type 2 diabetes. Methods：Retrograde analyzing 55 cases of gastric cancer with type 2 diabetes from 2004 to 2008.These patients were divided into three groups: distal gastrectomy with BillrothⅡanastomosis(n=25),total gastrectomy with esophago-jejunum Roux-en-Y anastomosis(n=19), distal gastrectomy with BillrothⅠanastomosis(n=11). Results：Comparing to the third group,the blood glucose level of the former two groups after surgery showed a steady and sustained descent(P< 0.05).The effective rate was 72.00% and 73.68% respectively.However, there was no difference in the control of diabetes between the former two groups(P>0.05). Conclusions：BillrothⅡanastomosis or Roux-en-Y anastomosis is an effective method for the patients of gastric cancer with type 2 diabetes.

Key words: Gastric cancer, Type 2 diabetes mellitus, BillrothⅠanastomosis, BillrothⅡanastomosis, Roux-en-Y anastomosis