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[目的]研究三种不同消化道重建方式对合并2型糖尿病的进展期胃癌患者的血糖影响。[方法]回顾性分析64例手术治疗合并2型糖尿病的进展期远端胃癌患者资料,其中行BillrothⅠ术式8例(A组),BillrothⅡ术式32例(B组),Roux-en-Y术式24例(C组)。[结果]64例患者均顺利完成根治性胃切除术,未发生严重并发症,随访9个月A组术后空腹血糖与术前比较差异均无统计学意义(P>0.05)。B、C两组术后空腹血糖与术前比较差异均具有统计学意义(P<0.05)。B、C两组术后糖尿病改善的总有效率为76.8%(43/56),痊愈率为39.3%(22/56)。[结论]胃转流术(BillrothⅡ式或Roux-en-Y式)能有效改善合并2型糖尿病的胃癌患者的糖代谢,同时也为糖尿病手术治疗提供了可行性依据。
[Objective] To investigate the effect of three different methods of gastrointestinal reconstruction on the blood glucose in patients with advanced gastric cancer complicated with type 2 diabetes. [Methods] A retrospective analysis of 64 cases of advanced gastric cancer patients with surgical treatment of type 2 diabetes mellitus, including 8 cases of Billroth Ⅰ operation (group A), 32 cases of Billroth Ⅱ operation (group B), Roux-en-Y 24 cases of surgery (C group). [Result] All the 64 patients successfully completed radical gastrectomy without serious complications. There was no significant difference in fasting blood glucose between the two groups at 9 months of follow - up (P> 0.05). The postoperative fasting blood glucose in groups B and C were significantly different from those before operation (P <0.05). The total effective rate of improvement of diabetes after operation in group B and C was 76.8% (43/56) and the cure rate was 39.3% (22/56). [Conclusion] Gastric bypass (Billroth Ⅱ or Roux-en-Y) can effectively improve the glucose metabolism in patients with type 2 diabetes and gastric cancer, and also provide a feasible basis for the surgical treatment of diabetes mellitus.