2型糖尿病外科治疗体会.docVIP

2型糖尿病外科治疗体会 　　[摘要] 目的：评价2型糖尿病的外科手术治疗效果。方法：总结我院11例2型糖尿病患者采用外科手术治疗的临床资料，比较手术前后血糖、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（IRI）的改变。结果：胃转流术后，患者平均空腹血糖（FBG）由术前的（12.4±2.6）mmol/L降至术后的（6.3±1.4）mmol/L，餐后2 h血糖（2 h PG）由（16.1±3.7）mmol/L降至（8.5±3.2）mmol/L，6个月后HbA1c由术前的（7.9±1.5）mmol/L降至术后（6.8±0.6）mmol/L，IRI由（6.6±0.9）mmol/L降至（3.2±0.4）mmol/L，差异均有高度统计学意义（均P0.01）。在11例患者中，治愈8例（72.8%），好转3例（27.2%）。结论：2型糖尿病患者，在经过长期的非手术治疗后效果不佳者，可考虑行胃肠外科手术治疗。 　　[关键词] 2型糖尿病；外科治疗；血糖 　　[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-7210（2011）11（b）-179-02 　　 　　Experiment of the surgical treatment for type 2 diabetes mellitus 　　REN Huiming, CAI Chongyuan, SHANGGUAN Changsheng 　　Department of General Surgery, the Second Peoples Hospital of Jingmen City, Hubei Province, Jingmen 448000, China 　　[Abstract] Objective: To evaluate the efficacy of the surgical treatment for patients with type 2 diabetic. Methods: Retrospective analysing of the clinical data of 11 patients with type 2 diabetes who had surgical treatment in our hospital. The changes of the preoperative and postoperative blood glucose, glycosylated hemoglobin (HbA1c), insulin resistance index (IRI) of patients were compared. Results: After gastric bypass (GBP), fasting plasma glucose (FBG) were decreased from (12.4±2.6)mmol/L (pre operative) to (6.3±1.4)mmol/L (post operative), and the 2 h plasma glucose (2 h PG) were decreased from (16.1±3.7)mmol/L (pre operative) to (8.5±3.2)mmol/L (post operative). After 6 months, HbA1c were decreased from (7.9±1.5)mmol/L (pre operative) to (6.8±0.6)mmol/L (post operative), IRI were decreased from (6.6±0.9)mmol/L (pre operative) to (3.2±0.4)mmol/L (post operative), there were all statistical significance (all P0.01). 8 cases (72.8%) were cured, 3 cases (27.2%) improved. Conclusion: Gastric bypass is effective, safe and feasible for patients with type 2 diabetes. 　　[Key words] Type 2 diabetes mellitus; Surgical treatmet; Blood glucose 　　 　　2型糖尿病（type 2 diabetes mellitus，T2DM）已经成为严重威胁人类健康的慢性疾病之一，由其所引起的冠心病、肾病、视网膜病及神经病变等是造成患者致死及致残的主要原因。随着减肥