CAJ | 학술논문

目的：探讨外科手术治疗2型糖尿病的临床疗效及安全性。方法将200例2型糖尿病患者随机分为两组，每组100例。对照组采用胰岛素注射治疗，治疗组采用腹腔镜手术或开腹手术进行治疗。观察治疗前后两组患者体质量指数（ BMI）、糖尿病相关指标与血脂水平的变化及并发症的发生情况，并比较两组的临床疗效。结果治疗组总有效率显著高于对照组，差异有统计学意义（ P <0.05）；治疗后，两组空腹血糖（ FBG）、餐后2 h血糖（2 hPBG）、C肽、糖化血红蛋白（HbA1c）及BMI均较治疗前明显降低（ P <0.05或P <0.01），且治疗组FBG、2 hPBG及BMI显著低于对照组，差异有统计学意义（ P <0.05或P <0.01）。治疗后，治疗组总胆固醇（ TC）、甘油三酯（ TG）和低密度脂蛋白胆固醇（ LDL-C）水平均较治疗前明显降低，而对照组仅TC水平明显降低，且治疗组治疗后上述各指标水平均显著低于对照组，差异有统计学意义（ P <0.05或P <0.01）；两组并发症比较，差异无统计学意义（ P >0.05）。结论外科手术能有降低2型糖尿病患者的血糖、血脂水平，减轻患者体质量，其疗效优于胰岛素注射，且安全性较好。
목적：탐토외과수술치료2형당뇨병적림상료효급안전성。방법장200례2형당뇨병환자수궤분위량조，매조100례。대조조채용이도소주사치료，치료조채용복강경수술혹개복수술진행치료。관찰치료전후량조환자체질량지수（ BMI）、당뇨병상관지표여혈지수평적변화급병발증적발생정황，병비교량조적림상료효。결과치료조총유효솔현저고우대조조，차이유통계학의의（ P <0.05）；치료후，량조공복혈당（ FBG）、찬후2 h혈당（2 hPBG）、C태、당화혈홍단백（HbA1c）급BMI균교치료전명현강저（ P <0.05혹P <0.01），차치료조FBG、2 hPBG급BMI현저저우대조조，차이유통계학의의（ P <0.05혹P <0.01）。치료후，치료조총담고순（ TC）、감유삼지（ TG）화저밀도지단백담고순（ LDL-C）수평균교치료전명현강저，이대조조부TC수평명현강저，차치료조치료후상술각지표수평균현저저우대조조，차이유통계학의의（ P <0.05혹P <0.01）；량조병발증비교，차이무통계학의의（ P >0.05）。결론외과수술능유강저2형당뇨병환자적혈당、혈지수평，감경환자체질량，기료효우우이도소주사，차안전성교호。
Objective To explore the clinical effect and safety of surgical operation in treatment of patients with type 2 diabetes mellitus ( T2DM). Methods Two hundred patients with T2DM were randomly divided into two groups,100 cases in each group. Patients in control group were given with injection of insulin,whereas patients in trial group were treated by laparoscopic surgery or laparotomy. The body mass index ( BMI),changes of DM-related indexes and blood lipids as well as the occurrence of complications were observed before and after treatment,and the clinical effects of two groups were also compared. Results The total effective rate of trial group was significantly higher than that of control group,and the difference was statistically significant( P <0. 01). After treatment,the levels of fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG),C peptide and glycosylated hemoglobin( HbA1c)and BMI were obviously decreased in comparison with those before treatment( P <0. 05 or P <0. 01),and levels of FBG and 2 hPBG and BMI in trial group were significantly lower than those of control group, and the difference was statistically significant( P <0. 05 or P <0. 01). After treatment,the levels of total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol( LDL-C)in trial group were evidently decreased in comparison with those before treatment,while TC level in control group was obviously decreased,and the above indexes in trial group were significantly lower than those of control group,and the differ-ence was statistically significant( P <0. 05 or P <0. 01). In comparison with the incidence of complications in these two groups,the difference was not obvious( P >0. 05). Conclusion Surgical operation can effectively decrease the levels of blood glucose and lipids as well as body weight in patients with T2DM,it is a better,safe and effective method,and it is superior to that of insulin injection.