CAJ | 학술논문

目的：分析胆囊切除术+Roux-en-Y胃肠转流术治疗2型糖尿病的近期和远期疗效。方法选取2009年3月-2015年3月胆囊结石并2型糖尿病患者95例，其中采用开腹胆囊切除切除术+Roux-en-Y胃肠转流术治疗的55例患者设为观察组，采用开腹胆囊切除术+术后药物治疗或胰岛素治疗糖尿病的40例患者设为对照组。对两组患者进行为期3年的随访，比较两组术前、术后不同时段的空腹血糖、餐后血糖、糖化血红蛋白、空腹胰岛素水平以及临床疗效和并发症发生情况。结果两组术前的空腹血糖、餐后血糖、糖化血红蛋白水平相当，差异无统计学意义(P>0.05)。术后1个月-1年，观察组的血糖水平持续稳定下降，对照组则持续上升，需采用药物或胰岛素控制。两组差异有统计学意义(P<0.05)。观察组术后1年和3年的治愈率显著优于对照组，差异有统计学意义(P<0.05)。结论胆囊切除术+Roux-en-Y胃肠转流术治疗胆囊结石并2型糖尿病，不仅能取得良好的结石治愈效果，还能有效控制患者的血糖水平，临床疗效良好。
목적：분석담낭절제술+Roux-en-Y위장전류술치료2형당뇨병적근기화원기료효。방법선취2009년3월-2015년3월담낭결석병2형당뇨병환자95례，기중채용개복담낭절제절제술+Roux-en-Y위장전류술치료적55례환자설위관찰조，채용개복담낭절제술+술후약물치료혹이도소치료당뇨병적40례환자설위대조조。대량조환자진행위기3년적수방，비교량조술전、술후불동시단적공복혈당、찬후혈당、당화혈홍단백、공복이도소수평이급림상료효화병발증발생정황。결과량조술전적공복혈당、찬후혈당、당화혈홍단백수평상당，차이무통계학의의(P>0.05)。술후1개월-1년，관찰조적혈당수평지속은정하강，대조조칙지속상승，수채용약물혹이도소공제。량조차이유통계학의의(P<0.05)。관찰조술후1년화3년적치유솔현저우우대조조，차이유통계학의의(P<0.05)。결론담낭절제술+Roux-en-Y위장전류술치료담낭결석병2형당뇨병，불부능취득량호적결석치유효과，환능유효공제환자적혈당수평，림상료효량호。
Objective To analyze the short-term and long-term efficacy of cholecystectomy and Roux-en-Y gastrointestinal bypass in the treatment of type 2 diabetes. Methods 95 cases with cholecystolithiasis and type 2 diabetes were selected. Of them, 55 cases treated by open cholecystectomy and Roux-en-Y gastrointestinal bypass were set as the observation group and 40 cases treated by open cholecystectomy and postoperative medication or insulin were set as the control group. Both groups were given a 3-year follow-up. And the level of fasting blood glucose, postprandial blood sugar, glycosylated hemoglobin, fasting insulin at different periods before and after surgery, clinical efficacy and incidence of complications were compared between the two groups. Results There was no statistically significant difference in the level of fasting blood glucose, postprandial blood sugar and glycosylated hemoglobin before surgery between the two group(P>0.05). The level of blood glucose of the observation group decreased stably and sustainedly during the period from 1 month to 1 year after surgery, while that of the control group increased sustainedly and the control group needed drugs or insulin to control the level of blood glucose, the difference between the two groups was statistically significant(P<0.05). The postoperative 1-year and 3-year cure rate of the observation group was much better than that of the control group, respectively with statistically significant difference(P<0.05). Conclusion For patients with cholecystolithiasis and type 2 diabetes, cholecystectomy and Roux-en-Y gastrointestinal bypass have good effect on curing the stone and controlling the blood glucose level effectively with good clinical efficacy.