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目的探讨不同消化道重建方式对胃癌合并2型糖尿病患者术后血糖的影响。方法回顾性分析某院2006年10月~2014年10月期间行根治性手术治疗30例胃癌合并2型糖尿病患者的临床资料,按照不同吻合方式将患者分为BillrothⅡ式组(9例)和Roux-en-Y组(21例)。统计并比较各组患者以下指标:(1)术前、术后1月、术后6月的空腹血糖(FBG)和餐后2小时(PG2h)血糖情况;(2)术前、术后6月的体重变化情况。采用SPSS11.5统计软件进行统计分析,手术前后各项指标的比较采用配对t检验。结果两组分别在术后1个月和术后6个月的FBG、PG2h水平均明显低于术前(P<0.05),但术后1个月和术后6个月的FBG、PG2h水平在组内比较差异不显著(P>0.05)。术后6个月时两组间FBG水平及体重比较差异均显著(P<0.05)。结论根据本组病例资料研究表明,采用Roux-en-Y或BillrothⅡ式吻合均可明显降低胃癌合并2型糖尿病患者的术后血糖水平,并且Roux-en-Y式吻合在控制术后血糖和体重方面相对具有一定的优势。
Objective To investigate the effect of different modes of gastrointestinal reconstruction on postoperative blood glucose in patients with gastric cancer complicated with type 2 diabetes mellitus. Methods The clinical data of 30 gastric cancer patients with type 2 diabetes undergoing radical surgery between October 2006 and October 2014 in our hospital from January 2006 to October 2014 were retrospectively analyzed. Patients were divided into Billroth Ⅱ group (n = 9) and Roux -en-Y group (21 cases). Statistics and comparison of the following indicators in each group of patients: (1) preoperative, postoperative January, postoperative 6 months of fasting blood glucose (FBG) and 2 hours postprandial (PG2h) blood glucose; (2) preoperative and postoperative 6 Month weight changes. Using SPSS11.5 statistical software for statistical analysis, before and after comparison of the indicators using paired t test. Results The levels of FBG and PG2h at 1 month and 6 months after operation in both groups were significantly lower than those before operation (P <0.05), but FBG and PG2h levels at 1 month and 6 months after operation There was no significant difference in the group (P> 0.05). There was significant difference in FBG level and body weight between the two groups at 6 months after operation (P <0.05). Conclusion According to the data of this group of patients, Roux-en-Y or Billroth Ⅱ anastomosis can significantly reduce postoperative blood glucose levels in patients with gastric cancer with type 2 diabetes mellitus, and Roux-en-Y anastomosis in the control of postoperative blood glucose and body weight Relatively has certain advantages.