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南京鼓楼医院集团宿迁市人民医院普外三科,江苏,宿迁,223800
纸质出版日期:2019,
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王建, 吴建强, 马小明, 等. 近端胃切除双通道吻合治疗非肥胖型2型糖尿病的疗效分析[J]. 局解手术学杂志, 2019,(9):757.
WANG Jian, WU Jianqiang, MA Xiaoming, et al. Efficacy analysis of dual-channel anastomosis after proximal gastrectomy in nonobese type 2 diabetes mellitus patients[J]. null, 2019,(9):757.
目的 探讨近端胃切除后残胃空肠双通道吻合术治疗非肥胖型2型糖尿病(T2DM)的临床效果。方法 回顾性分析我院2015年6月至2016年9月收治的55例近端胃癌合并T2DM、且BMI<27.5 kg/m2患者的临床资料。其中接受近端胃切除后残胃空肠双通道吻合(双通道组)25例,全胃切除+Roux-en-Y吻合(全胃R-Y组)30例,统计2组患者手术情况、手术前后血糖变化及术后营养指标等情况。结果 2组患者术后空腹血糖、餐后2 h血糖、糖化血红蛋白水平较术前明显降低,差异有统计学意义(P<0.05);2组患者血糖改善程度比较,差异无统计学意义(P>0.05)。术后12个月
双通道组完全缓解率为68%,全胃RY组完全缓解率为66%,差异无统计学意义(χ2=2.843,P>0.05);双通道组BMI、血红蛋白、血浆白蛋白等营养指标明显优于全胃RY组,2组比较差异有统计学意义(P<0.05)。结论 近端胃切除后双通道吻合术和全胃切除+Roux-en-Y吻合术对非肥胖型T2DM患者的治疗均有良好效果,但前者在术后营养状况方面更具优势。
Objective To investigate the efficacy of dualchannal anastomosis of residual stomach and jejunum after proximal gastrectomy in nonobese type 2 diabetes mellitus patients.Methods Retrospectively analyzed the clinical data of 55 patients of proximal stomach cancer complicated with type 2 diabetes mellitus (BMI<27.5 kg/m2)who were admitted into our hospital from June 2015 to September 2016. Among them
25 patients received dualchannel anastomosis of gastric jejunum after proximal gastrectomy (dualchannel group)
and the other 30 patients received Roux-en-Y jejunostomy after total gastrectomy (R-Y group).The changes of blood glucose before and after operation and the nutritional indexes after operation were analyzed.Results The levels of fasting blood glucose
postprandial blood glucose and glycosylated hemoglobin in the two groups were significantly lower than those before the operation
and the differences were statistically significant (P<0.05).There was no statistically significant difference in blood glucose improvement between the two groups (P>0.05).Twelve months after surgery
the complete response rate in the dualchannel group was 68%
and it was 66% in the R-Y group
and there was no significant difference between the two groups (χ2=2.843,P>0.05).Nutritional indexes such as BMI
hemoglobin and plasma albumin in the dualchannel group were significantly better than those in the R-Y group
and the difference between the two groups was statistically significant (P<0.05). Conclusion Both dualchannel anastomosis after proximal gastrectomy and RouxenY jejunostomy after total gastrectomy can receive good effect for the treatment of nonobese T2DM patients
but the former has more advantages in terms of postoperative nutritional status.
2型糖尿病双通道吻合胃癌BMI近端胃切除营养状态
type 2 diabetes mellitusdual-channal anastomosisstomach cancerBMIproximal gastrectomynutritional states
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