CAJ | 학술논문

目的：探讨不同消化道重建方式对2型糖尿病患者胃切除后血糖代谢的影响°方法将2012年3月—2013年3月在该院行根治术的100例胃癌合并2型糖尿病患者按不同消化道重建方式分为BillrothⅠ式组33例,BillrothⅡ式组36例, Roux-en-Y式组31例,综合分析3组患者术前、术后血糖变化°结果①BillrothⅠ式组患者术后1周、术后1个月、术后6个月的空腹血糖(FBG﹚及餐后2 h血糖(PG-2h﹚水平与术前比较差异无统计学意义(P>0.05﹚；②BillrothⅡ式组术前及术后1周、1个月、6个月的空腹血糖分别为(8.730±0.859﹚mmol/L、(7.328±0.706﹚mmol/L、(6.512±0.714﹚mmol/L、(6.802±0.813﹚mmol/L,餐后2 h血糖分别为(11.974±0.918﹚mmol/L、(7.429±1.432﹚mmol/L、(7.504±1.019﹚mmol/L、(7.657±2.033﹚mmol/L；Roux-en-Y式组术前及术后1周、1个月、6个月的空腹血糖分别为(8.972±0.843﹚mmol/L、(7.226±0.516﹚mmol/L、(6.468±0.533﹚mmol/L、(6.7042±0.721﹚mmol/L,餐后2 h血糖分别为(11.938±0.957﹚mmol/L、(7.024±1.917﹚mmol/L、(7.382±1.614﹚mmol/L、(7.665±1.953﹚mmol/L,BillrothⅡ式组和Roux-en-Y式组术后1周、术后1个月、术后6个月的空腹血糖及餐后2 h血糖水平均明显低于术前(P<0.05﹚°结论BillrothⅡ式手术和Roux-en-Y式手术能够有效改善胃癌合并2型糖尿病患者术后血糖代谢°
목적：탐토불동소화도중건방식대2형당뇨병환자위절제후혈당대사적영향°방법장2012년3월—2013년3월재해원행근치술적100례위암합병2형당뇨병환자안불동소화도중건방식분위BillrothⅠ식조33례,BillrothⅡ식조36례, Roux-en-Y식조31례,종합분석3조환자술전、술후혈당변화°결과①BillrothⅠ식조환자술후1주、술후1개월、술후6개월적공복혈당(FBG﹚급찬후2 h혈당(PG-2h﹚수평여술전비교차이무통계학의의(P>0.05﹚；②BillrothⅡ식조술전급술후1주、1개월、6개월적공복혈당분별위(8.730±0.859﹚mmol/L、(7.328±0.706﹚mmol/L、(6.512±0.714﹚mmol/L、(6.802±0.813﹚mmol/L,찬후2 h혈당분별위(11.974±0.918﹚mmol/L、(7.429±1.432﹚mmol/L、(7.504±1.019﹚mmol/L、(7.657±2.033﹚mmol/L；Roux-en-Y식조술전급술후1주、1개월、6개월적공복혈당분별위(8.972±0.843﹚mmol/L、(7.226±0.516﹚mmol/L、(6.468±0.533﹚mmol/L、(6.7042±0.721﹚mmol/L,찬후2 h혈당분별위(11.938±0.957﹚mmol/L、(7.024±1.917﹚mmol/L、(7.382±1.614﹚mmol/L、(7.665±1.953﹚mmol/L,BillrothⅡ식조화Roux-en-Y식조술후1주、술후1개월、술후6개월적공복혈당급찬후2 h혈당수평균명현저우술전(P<0.05﹚°결론BillrothⅡ식수술화Roux-en-Y식수술능구유효개선위암합병2형당뇨병환자술후혈당대사°
Objective To investigate the effects of different alimentary reconstruction for gastrectomy on the glucose metabolism in patients complicated with type 2 diabetes. Methods 100 cases who underwent radical surgery for gastric cancer complicated with type 2 diabetes in our hospital from March 2012 to March 2013 were divided into BillrothⅠ group (33 cases), BillrothⅡgroup(36 cases) and Roux-en-Y group (31 cases) according to different alimentary reconstruction. And the blood glucose levels of three groups before and after operation were analyzed comparatively and comprehensively. Results ①In BillrothⅠ group, there was no significant difference in levels of FBG and PG-2h before operation and 1 week, 1 month, 6 months after operation (P>0.05); ②In BillrothⅡ group, the levels of FBG before operation, 1 week, 1 month, 6 months after operation were (8.730 ±0.859)mmol/L, (7.328±0.706)mmol/L, (6.512±0.714)mmol/L, (6.802±0.813)mmol/L, respectively, and the levels of PG-2h before operation, 1 week, 1 month, 6 months after operation were (11.974±0.918)mmol/L, (7.429±1.432)mmol/L, (7.504±1.019)mmol/L, (7.657±2.033)mmol/L, respectively. In Roux-en-Y group, the levels of FBG before operation, 1 week, 1 month, 6 months after operation were (8.972± 0.843)mmol/L, (7.226 ±0.516)mmol/L, (6.468 ±0.533)mmol/L, (6.7042 ±0.721)mmol/L, respectively, and the levels of PG-2h before operation, 1 week, 1 month, 6 months after operation were (11.938±0.957)mmol/L, (7.024±1.917)mmol/L, (7.382±1.614)mmol/L, (7.665±1.953)mmol/L, respectively. In BillrothⅡ group and Roux-en-Y group, the levels of FBG and PG-2h 1 week, 1 month, 6 months after operation were much lower than those before operation (P<0.05). Conclusion Billroth II or Roux-en-Y type operation can effectively improve the postoperative glucose metabolism of gastric cancer patients with type 2 diabetes.