CAJ | 학술논문

目的：探讨Roux-en-Y消化道重建术对胃癌合并2型糖尿病患者血糖的影响。方法回顾性分析该院于2010年-2014年6月收治的52例以Roux-en-Y消化道重建行手术治疗的胃癌合并2型糖尿病患者，比较术前、术后1、3、6个月的空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、体重指数(BMI)的变化情况，密切关注术后的降糖药物使用情况。结果Roux-en-Y消化道重建术术后所有患者的空腹及餐后血糖均较术前逐渐降低(P<0.05),伴随着术后血糖的改善，HbA1c较术前逐渐下降(P<0.05)；患者术后各时间段BMI较术前均无明显变化(P>O.05)。52例患者中，8例(15.3%)术后出院时血糖达正常水平，停用降糖药物；17例(32.7%)于术后3个月内停药；9例(17.3%)于术后3~6个月停药；18例(34.6%)于术后6个月仍在使用降糖药物，但用药剂量均有不通程度的减少，目前仍在随访。结论Roux-en-Y消化道重建术是治疗2型糖尿病的有较方法。
목적：탐토Roux-en-Y소화도중건술대위암합병2형당뇨병환자혈당적영향。방법회고성분석해원우2010년-2014년6월수치적52례이Roux-en-Y소화도중건행수술치료적위암합병2형당뇨병환자，비교술전、술후1、3、6개월적공복혈당、찬후2 h혈당、당화혈홍단백(HbA1c)、체중지수(BMI)적변화정황，밀절관주술후적강당약물사용정황。결과Roux-en-Y소화도중건술술후소유환자적공복급찬후혈당균교술전축점강저(P<0.05),반수착술후혈당적개선，HbA1c교술전축점하강(P<0.05)；환자술후각시간단BMI교술전균무명현변화(P>O.05)。52례환자중，8례(15.3%)술후출원시혈당체정상수평，정용강당약물；17례(32.7%)우술후3개월내정약；9례(17.3%)우술후3~6개월정약；18례(34.6%)우술후6개월잉재사용강당약물，단용약제량균유불통정도적감소，목전잉재수방。결론Roux-en-Y소화도중건술시치료2형당뇨병적유교방법。
Objective To explore the influence of blood glucose in gastric cancer patients with type 2 diabetes by Roux-en-Y gastric bypass. Methods Retrospective analysis 52 gastric cancer patients with type 2 diabetes mellitus who underwent Roux-en-Y gastric bypass, observed data as fasting blood-glucose(FBG) ,2-Hour postprandial blood sugar(2hPG), Glycosylated hemoglobin (HbA1c) and body mass index (BMI), and details before and in 1,3,6 months after operation. Close attention to the use of hypo-glycemic drugs after operation. Results After with Roux-en-Y reconstruction of gastrointestinal surgery, there were significant dif-ferences of FBG and 2hPG (P<0.05) in all patients, along with the improvement in blood glucose, there was significant difference of HbA1c (P<0.05); there was no significant difference of BMI in each period after surgery compare with preoperative. In 52 pa-tients,8 cases (15.3%) reached the normal level of blood glucose after operation, discontinued antidiabetic drugs;17 cases (32.7%) withdrawal within 3 months after operation;9 cases (17.3%) after 3-6 months withdrawal;18 cases (34.6%) in the postoperative 6 month still in use of hypoglycemic drugs but the drug dosage was impassability degree reduced, at present still in follow-up. Con-clusion The study shows that the Roux-en-Y gastric bypass is aneffective method for the type 2 diabetes mellitus.