中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
5期
536-538
,共3页
苏杰%冯祯声%邱光庭%蔡澄%高勤革
囌傑%馮禎聲%邱光庭%蔡澄%高勤革
소걸%풍정성%구광정%채징%고근혁
胃癌%糖尿病
胃癌%糖尿病
위암%당뇨병
Gastric cancer%Diabetes mellitus
目的 探讨胃癌根治术合并2型糖尿病患者采用不同手术策略对术后血糖变化的影响.方法 回顾性分析行胃癌根治性手术的68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,毕Ⅰ式吻合术26例(A组),毕Ⅱ式吻合术22例(B组),Roux-en-Y吻合术20例(C组).比较3组患者术前及术后1周、1月、6月的空腹血糖水平.结果 B、C组患者术后1个月与6个月的血糖水平与术前相比明显好转[(10.03±5.12)、(8.44±5.21) mmol/L与(13.56±3.36) mmol/L;(10.61±3.16)、(7.68 ±4.88) mmol/L与(12.84 ±3.36) mmol/L],且B、C组患者术后1个月与6个月的血糖水平均较A组下降明显[(10.03±5.12)、(8.44±5.21) mmol/L与(11.12±6.32) mmol/L；(10.61±3.16)、(7.68±4.88) mmol/L与(11.12 ±6.32) mmol/L](P均＜0.05).而B、C组之间上述两指标比较差异均无统计学意义(P均＞0.05).3组患者术后情况,以B、C组患者的糖尿病好转较为明显,其中近50％的患者治愈,血糖控制正常,另一部分除少数无效外,糖尿病药物治疗降级,手术效果显著.结论毕Ⅱ式吻合、Roux-en-Y吻合术对于合并2型糖尿病的胃癌患者具有良好的血糖控制作用,患者术后血糖改变与胃空肠吻合术式有关.
目的 探討胃癌根治術閤併2型糖尿病患者採用不同手術策略對術後血糖變化的影響.方法 迴顧性分析行胃癌根治性手術的68例胃癌閤併2型糖尿病患者術前及術後的血糖變化,按重建方式不同分為3組,畢Ⅰ式吻閤術26例(A組),畢Ⅱ式吻閤術22例(B組),Roux-en-Y吻閤術20例(C組).比較3組患者術前及術後1週、1月、6月的空腹血糖水平.結果 B、C組患者術後1箇月與6箇月的血糖水平與術前相比明顯好轉[(10.03±5.12)、(8.44±5.21) mmol/L與(13.56±3.36) mmol/L;(10.61±3.16)、(7.68 ±4.88) mmol/L與(12.84 ±3.36) mmol/L],且B、C組患者術後1箇月與6箇月的血糖水平均較A組下降明顯[(10.03±5.12)、(8.44±5.21) mmol/L與(11.12±6.32) mmol/L；(10.61±3.16)、(7.68±4.88) mmol/L與(11.12 ±6.32) mmol/L](P均＜0.05).而B、C組之間上述兩指標比較差異均無統計學意義(P均＞0.05).3組患者術後情況,以B、C組患者的糖尿病好轉較為明顯,其中近50％的患者治愈,血糖控製正常,另一部分除少數無效外,糖尿病藥物治療降級,手術效果顯著.結論畢Ⅱ式吻閤、Roux-en-Y吻閤術對于閤併2型糖尿病的胃癌患者具有良好的血糖控製作用,患者術後血糖改變與胃空腸吻閤術式有關.
목적 탐토위암근치술합병2형당뇨병환자채용불동수술책략대술후혈당변화적영향.방법 회고성분석행위암근치성수술적68례위암합병2형당뇨병환자술전급술후적혈당변화,안중건방식불동분위3조,필Ⅰ식문합술26례(A조),필Ⅱ식문합술22례(B조),Roux-en-Y문합술20례(C조).비교3조환자술전급술후1주、1월、6월적공복혈당수평.결과 B、C조환자술후1개월여6개월적혈당수평여술전상비명현호전[(10.03±5.12)、(8.44±5.21) mmol/L여(13.56±3.36) mmol/L;(10.61±3.16)、(7.68 ±4.88) mmol/L여(12.84 ±3.36) mmol/L],차B、C조환자술후1개월여6개월적혈당수평균교A조하강명현[(10.03±5.12)、(8.44±5.21) mmol/L여(11.12±6.32) mmol/L；(10.61±3.16)、(7.68±4.88) mmol/L여(11.12 ±6.32) mmol/L](P균＜0.05).이B、C조지간상술량지표비교차이균무통계학의의(P균＞0.05).3조환자술후정황,이B、C조환자적당뇨병호전교위명현,기중근50％적환자치유,혈당공제정상,령일부분제소수무효외,당뇨병약물치료강급,수술효과현저.결론필Ⅱ식문합、Roux-en-Y문합술대우합병2형당뇨병적위암환자구유량호적혈당공제작용,환자술후혈당개변여위공장문합술식유관.
Objective To observe the effect of gastrectomy for gastric cancer on blood glucose in patients complicated with type 2 diabetes mellitus by using different operation strategies.Methods The retrospective analysis was carried out of 68 cases who undergone radical surgery for gastric cancer and complicated with type 2 diabetes mellitus.These patients were divided into 3 groups by different kinds of digestive tract reconstruction,Billroth Ⅰ (n =26),Billroth Ⅱ (n =22) and Roux-en-Y (n =20).The levels of fasting blood glucose (FBG) were detected before and after operation one week,one month and six months in three groups.Results Comparing to the level before operation,the level of FBG after operation showed a descent in group B and group C((10.03 ±5.12) vs.(13.56 ±3.36) mmol/L; (8.44 ±5.21) vs.(13.56 ±3.36) mmol/L;(10.61 ±3.16) vs.(12.84 ±3.36) and(7.68 ±4.88) vs.(12.84 ±3.36) mmol/L) which was better than group A((10.03 ±5.12)vs.(11.12 ±6.32),(8.44 ±5.21) vs.(11.12 ±6.32) mmol/L;(10.61 ±3.16) vs.(11.12 ±6.32) mmol/L),(7.68 ±4.88) vs.(11.12 ±6.32) mmol/L;P＜0.05,but there was no significantly difference between B and group C (P ＞ 0.05).The 3 groups of patients,with B,C groups of patients with diabetes improved obviously,of which nearly 50％ of patients cured,normal blood sugar control,the other part with the exception of a few effective,degradation of diabetes drug treatment,and operation effect was significant.Conclusion It is effective to control the blood glucose of gastric cancer patients complicated with type 2 diabetes with Billroth II or Roux-en-Y gastrectomy.There is a correlation between postoperative blood glucose change and different gastrojejunal anastomosis.
