CAJ | 학술논문

目的探讨胃旁路术消化道重建在胃癌合并2型糖尿病患者外科治疗中的临床应用价值.方法回顾分析2008年6月~2012年2月5例胃癌合并2型糖尿病患者在行胃癌根治的同时,参考胃旁路术中消化道重建原理行胃肠道重建,术后观察患者血糖、体重、进食、营养及消化道瘘、肠梗阻等发生状况.结果5例患者血糖均较前术前明显下降,其中2例患者3周后口服降糖药物剂量较术前减半,并停用注射胰岛素.另外3例降糖药物由两种联合用药降为单一用药,且血糖控制在5.6~6.7mmol/L.未出现切口裂开、感染、营养不良、消化道瘘及肠梗阻等病例.结论在胃癌合并2型糖尿病患者的根治术中参考胃旁路术进行消化道重建,术后血糖可得到较好控制,不增加并发症的发生.
목적탐토위방로술소화도중건재위암합병2형당뇨병환자외과치료중적림상응용개치.방법회고분석2008년6월~2012년2월5례위암합병2형당뇨병환자재행위암근치적동시,삼고위방로술중소화도중건원리행위장도중건,술후관찰환자혈당、체중、진식、영양급소화도루、장경조등발생상황.결과5례환자혈당균교전술전명현하강,기중2례환자3주후구복강당약물제량교술전감반,병정용주사이도소.령외3례강당약물유량충연합용약강위단일용약,차혈당공제재5.6~6.7mmol/L.미출현절구렬개、감염、영양불량、소화도루급장경조등병례.결론재위암합병2형당뇨병환자적근치술중삼고위방로술진행소화도중건,술후혈당가득도교호공제,불증가병발증적발생.
Objective To study the clinical treatment value of digestive tract reconstruction in gastric bypass surgery on patients with gastric cancer complicated with type 2 diabetes mellitus.Method 5 patients of gastric cancer complicated with T2DM from June 2008 to February 2012 were randomly and retrospectively analyzed.According to the theory of gastric bypass,these patients got digestive tract reconstruction,with distal or total gastrectomy simultaneously.After operation,we observed effects on glucose,weight,appetite,nutrition,dige-stive tract fistula,intestinal obstruction,and so forth.Results The blood-glucose in all 5 patients was decreasing compared to the level before operation.2 of them took half of dose of hypoglycemic drugs,even disable insulin injection in three weeks after operation.3 of them got hypoglycemic treatment from combined medicine to simple one,and the IVBG level returned to normal(5.6~6.7mmol/L).All 5 patients survived the operation and no severe postoperative complications occurred.Conclusion The IVBG level can be decreased sharply in patients of gastric cancer complicated with T2DM,even to be normal after alimentary tract reconstruction by means of theory of gastric bypass.No more complications happen.