中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2009年
1期
35-37
,共3页
胃切除术%消化道重建%2型糖尿病
胃切除術%消化道重建%2型糖尿病
위절제술%소화도중건%2형당뇨병
Gastrectomy%Alimentary tract reconstruction%NIDDM
目的 探讨胃切除术后不同消化道重建方式对2型糖尿病(NIDDM)患者治疗效果的影响.方法 回顾性分析我科2005年1月至2008年1月收治的24例不合并肥胖NIDDM的胃癌及壶腹周围癌患者接受不同消化道重建术前后血糖及胰岛素用量的变化情况,其中毕1式胃肠吻合8例(BI组);Whipple术组10例;全胃切除、食道空肠Roux-en-y吻合组6例.结果 BI组手术前后血糖平均水平变化差异无统计学意义(P＞0.05);Whipple组、全胃组术后1、2个月起血糖平均水平与术前比较差异有统计学意义(P<0.001);BI组5例术前应用胰岛素,2例术后胰岛素用量不变,2例增量,1例减量;whipple组6例术前应用胰岛素,2例术后停用胰岛素,4例减量;全胃组4例术前应用胰岛素,2例术后停用胰岛素,2例减量.结论 全胃切除及Whipple术降低了不合并肥胖NIDDM患者的血糖水平及胰岛素用量.胃切除术后消化道重建治疗对不合并肥胖NIDDM的效果是肯定的.
目的 探討胃切除術後不同消化道重建方式對2型糖尿病(NIDDM)患者治療效果的影響.方法 迴顧性分析我科2005年1月至2008年1月收治的24例不閤併肥胖NIDDM的胃癌及壺腹週圍癌患者接受不同消化道重建術前後血糖及胰島素用量的變化情況,其中畢1式胃腸吻閤8例(BI組);Whipple術組10例;全胃切除、食道空腸Roux-en-y吻閤組6例.結果 BI組手術前後血糖平均水平變化差異無統計學意義(P＞0.05);Whipple組、全胃組術後1、2箇月起血糖平均水平與術前比較差異有統計學意義(P<0.001);BI組5例術前應用胰島素,2例術後胰島素用量不變,2例增量,1例減量;whipple組6例術前應用胰島素,2例術後停用胰島素,4例減量;全胃組4例術前應用胰島素,2例術後停用胰島素,2例減量.結論 全胃切除及Whipple術降低瞭不閤併肥胖NIDDM患者的血糖水平及胰島素用量.胃切除術後消化道重建治療對不閤併肥胖NIDDM的效果是肯定的.
목적 탐토위절제술후불동소화도중건방식대2형당뇨병(NIDDM)환자치료효과적영향.방법 회고성분석아과2005년1월지2008년1월수치적24례불합병비반NIDDM적위암급호복주위암환자접수불동소화도중건술전후혈당급이도소용량적변화정황,기중필1식위장문합8례(BI조);Whipple술조10례;전위절제、식도공장Roux-en-y문합조6례.결과 BI조수술전후혈당평균수평변화차이무통계학의의(P＞0.05);Whipple조、전위조술후1、2개월기혈당평균수평여술전비교차이유통계학의의(P<0.001);BI조5례술전응용이도소,2례술후이도소용량불변,2례증량,1례감량;whipple조6례술전응용이도소,2례술후정용이도소,4례감량;전위조4례술전응용이도소,2례술후정용이도소,2례감량.결론 전위절제급Whipple술강저료불합병비반NIDDM환자적혈당수평급이도소용량.위절제술후소화도중건치료대불합병비반NIDDM적효과시긍정적.
Objective To research the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus(non-insulin-dependent diabetes mellitus, NIDDM). Methods From January 2005 to January 2008, perioperative blood glucose level and insulin therapy in 24 gastric cancer or periampullary carcinoma patients with non-obesity type 2 diabetes were retrospectively analyzed. These patients underwent different alimentary tract reconstruction, including 8 patients for Billroth I, 10 for standard Whipples operation, 6 for esophageal Roux-en-Y jejunostomy after total gastrectomy. Glucose level and insulin dosage of thease patients were compared. Results In the patients underwent Billroth I operation, change of blood glucose level before and after operation was not significant(P＞0.05). The level of blood glucose in patients underwent Whipples operation and total gastrectomy were significant changed 1 and 2 months after the operation (P<0.001). In Billroth I group, 5 patients used insulin to control hyperglycemia preoperatively. After the operation, 2 patents maintained preoperative insulin dosage, 2 had to increase the use of insulin and 1 decreased the insulin dosage. In Whipples group, 6 patients used insulin preoperatively. Interestingly, 4 patents needed less insulin to control hyperglycemia and 2 were free of insulin dependance. In total gastrectomy group, there were 4 patients using insulin to control hyperglycemia. After the operation, 2 patents needed less insulin dosage and 2 stopped using insulin. Conclusions Both Whipples operation and total gastrectomy lead to decreased blood glucose level in NIDDM patients and less need of insulin.The effect of some types of alimentary tract reconstruction after gastrectomy on treatment of type 2 diabetes mellitus is assertive.
