胃转流术对胃癌合并2型糖尿病患者血糖影响临床研究.docVIP

胃转流术对胃癌合并2型糖尿病患者血糖影响临床研究 　　[摘要] 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 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。 　　[关键词] Roux-en-Y消化道重建术；胃癌；2型糖尿病 　　[中图分类号] R73 [文献标识码] A [文章编号] 1674-0742（2015）04（c）-0080-03 　　[Abstract] 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 hypoglycemic drugs after operation. Results After with Roux-en-Y reconstruction of gastrointestinal surgery， there were significant differences of FBG and 2hPG （P0.05） 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 patients，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. Conclusion The study shows that the Roux-en-Y gastric bypass is aneffective method for the type 2 diabetes mellitus. 　　[Key words] Roux-en-Y digestive tract reconstruction； Gastric cancer； Type 2 diabetes mellitus