胃癌合并2型糖尿病消化道重建后血糖变化观察

目的：观察采用不同消化道重建术式对于胃癌合并2型糖尿病患者术后血糖变化的影响。方法：胃癌合并2型糖尿病并行胃癌根治术患者共52例,根据术中消化道重建方式不同将上述患者分为3组,采用BillrothⅠ式吻合术22例为A组,采用BillrothⅡ＋Braun式吻合术18例为B组,采用Roux-en-Y吻合术12例为C组。观察所有患者术前﹑术后1个月﹑术后6个月﹑术后1年的空腹血糖（FBG）及餐后2 h血糖（2hPG）情况。结果：B、C组术后1个月、6个月及1年的FBG及2hPG均优于同时相点的A组（P〈0.01）;术后1年A、B和C组血糖控制有效率分别为22.7%、72.2%和75.0%,B、C组与A组比较,差异有统计学意义（P〈0.0167）。结论：采用BillrothⅡ＋Braun式吻合术或Roux-en-Y吻合术可有效降低胃癌合并2型糖尿病患者术后血糖水平。

Observation of different digestive tract reconstruction for gastric cancer on blood glucose in patients complicated with type 2 diabetes

Objective： To observe the effect of different digestive tract reconstruction after radical surgery for gastric cancer on blood glucose in patients complicated with type 2 diabetes.Methods： The retrospective analysis was made in 52 cases who undergone radical surgery for gastric cancer and complicated with type 2 diabetes from January,2008 to January,2010.These patients were divided into 3 groups by different kinds of digestive tract reconstruction-BillrothⅠ（n=22）,BillrothⅡ＋Braun（n=18） and Roux-en-Y（n=12）.The levels of fasting blood glucose（FBG） and 2h postprandial blood glucose（2hPG） were detected before operation and after operation one month,six months and one year in three groups.Results： Comparing to the level before operation,the levels of FBG and 2hPG after operation one month,six months and one year showed a descent in group BillrothⅡ＋Braun and group Roux-en-Y（P0.01）,and there was also more improvement than group BillrothⅠ.The effect rates of blood glucose control after operation one year were 22.7%,72.2%,75.0% for group BillrothⅠ,group BillrothⅡ＋Braun and group Roux-en-Y respectively.And there was difference among the three groups（P0.0167）.Conclusion： It is effective for controlling the blood glucose of gastric cancer patients complicated with type 2 diabetes with Billroth II or Roux-en-Y gastrectomy after radical surgery.