回盲肠间置代幽门术对糖代谢作用的影响

目的研究将回盲肠间置幽门替代术应用于胃肠道重建中的可行性。方法将21例成年健康小型猪分为3组:假手术对照组、BⅠ式组和远端胃大部切除带蒂回盲肠间置幽门替代手术组(回盲肠间置组),在术后60和120d时口服葡萄糖后在0、30、60、90和120min用快速血糖试纸法测血糖浓度,比较胃对流质的排空情况,观察术后动物恢复情况。结果术后2个月,峰值血糖浓度BⅠ式组为(7.8±1.0)mmol/L,回盲肠间置组为(7.1±0.8)mmol/L,假手术对照组为(4.1±0.4)mmol/L;前两组与假手术对照组比较,差异均有非常显著的统计学意义(P<0.01)。4个月后,回盲肠间置组峰值血糖浓度为(5.2±0.8)mmol/L,对照组(4.2±0.5)mmol/L,BⅠ式组(6.9±1.0)mmol/L。回盲肠间置组与假手术对照组比较,差异无统计学意义(P>0.05);但这两组与BⅠ式组比较,差异均有非常显著的统计学意义(P<0.01)。结论回盲肠间置幽门替代术重建消化道具有可行性。

Effect of ileocecum interposition graft as pylorus replacement on glycometabolism

OBJECTIVE: To evaluate the application of ileocecum interposition (ii) graft as pylorus replacement in alimentary reconstruction. METHODS: Twenty- one minipigs were randomly divided into three groups: sham operation group (control group), B - i group and ii group. The levels of blood glucose were measured by quick blood glucose testing of paper at 0, 30, 60, 90, and 120 minutes of oralglucose after 60 and 120 post- operative days to compare gastric empting of liquid feeds. RESULTS: Two months after operation,the peak of blood glucose was (7.8+/- 1.0)mmol/ L, (7.1+/- 0.8)mmol/ L, (4.1+/- 0.4)mmol/ L in B - i, ii group and control group respectively, there were significant differences between the two operation groups and control group (P< 0.01). Four months after operation, the peak of blood glucose was (6.9+/- 1.0) mmol/ L, (5.2+/- 0.8)mmol/ L, (4.2+/- 0.5)mmol/ L, respectively, there was no significant difference between ii group and control group (P > 0.05),but there were significant differences between both of the above two groups and B - i group (P< 0.01). CONCLUSION: The ileocecum interposition graft can offer specific advantages over current reconstruction procedures.