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目的探讨Roux-en-Y消化道重建手术对贲门癌合并2型糖尿病患者行根治性全胃切除术后血糖的影响。方法应用根治性全胃切除、Roux-en-Y吻合治疗贲门癌合并2型糖尿病患者32例,比较术前及术后不同时间(1周、1、3、6、12、24个月)体重,体重指数(BMI),空腹血糖,餐后2h血糖,糖化血红蛋白,C-肽,胰岛素水平,胰岛素抵抗指数的变化。结果本组32例患者,术后不同时间体重及体重指数无明显变化,空腹血糖,餐后2h血糖,糖化血红蛋白,C-肽,胰岛素水平,胰岛素抵抗与术前比较,均有明显下降(P<0.05)。结论 Roux-en-Y消化道重建对贲门癌合并2型糖尿病的患者术后血糖有良好的控制作用,对2型糖尿病的疗效确切可靠。
Objective To investigate the effect of Roux-en-Y gastrointestinal reconstructive surgery on blood glucose in patients with cardia cancer and type 2 diabetes after radical gastrectomy. Methods Thirty-two patients with cardia carcinoma and type 2 diabetes mellitus were treated with radical total gastrectomy and Roux-en-Y anastomosis. The body weight of patients with type 2 diabetes mellitus were compared before and after operation (1 week, 1, 3, 6, 12, 24 months) , Body mass index (BMI), fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin, C-peptide, insulin and insulin resistance index. Results There were no significant changes in body weight and body mass index at different time points in the 32 patients. Fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin, C-peptide, insulin and insulin resistance were significantly decreased compared with those before operation (P <0.05). Conclusion Roux-en-Y digestive tract reconstruction has a good control effect on postoperative blood glucose in patients with cardia cancer and type 2 diabetes mellitus, and the effect of type 2 diabetes mellitus is reliable.