【摘要】 目的:探讨Roux-en-Y吻合重建术对胃窦癌合并2型糖尿病(T2DM)患者血糖水平、胰岛功能及术后生存质量的影响。方法:选取2010年1月—2014年1月收治的68例I~II期胃窦癌合并T2DM患者为研究对象,根据患者手术方式将其分为胃十二指肠吻合组(对照组)32例,Roux-en-Y吻合重建组(观察组)36例,对比分析2组患者术前、术后6个月体质量指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、空腹C肽(FCP)水平。术前、术后6个月对2组患者行口服葡萄糖耐量试验(OGTT),检测及比较2组餐后2h血糖(2h FPG)、餐后2 h胰岛素(2h INS)及餐后2 h C肽(2h CP),计算2组胰岛素抵抗指数(HOMA-IR)。术前及术后6个月采用肿瘤生存质量量表(QOL)对2组患者生存质量进行评价。结果:对照组术后6个月BMI、FPG、Hb A1c、FINS、FCP、2h FPG、2h INS、2h CP、HOMA-IR与术前相比差异无统计学意义(P>0.05)。观察组术后6个月FPG、Hb A1c、2h FPG、HOMA-IR水平显著低于术前,而FINS、FCP、2h INS、2h CP较术前显著升高(P<0.05)。术后6个月观察组食欲、睡眠、自理能力、心理能力、疾病认识以及总生存质量评分均高于对照组(P<0.05)。结论:Roux-en-Y吻合术能有效提高胃窦癌合并T2DM患者胰岛β细胞功能,降低血糖水平,提高患者生存质量。更多还原

【Abstract】 Objective: To investigate the effects of blood glucose levels, insulin function and 775 quality of life after surgery of Roux-en-Y gastric anastomosis reconstruction of type 2 diabetes mellitus(T2DM). Methods: 68 cases of stage I- II patients with gastric cancer combined T2 DM period were divided into esophag ogastric anastomosis group(control group, n=32), Roux-en-Y anastomosis surgery group(observation group, n=36)from January 2010 to January 2014. The body mass index(BMI), the levels of fasting blood glucose(FPG), glycated hemoglobin(Hb A1c), fasting insulin(FINS), fasting C-peptide(FCP), 2 h postprandial blood glucose(2h FPG), 2 h postprandial insulin(2h INS)and postprandial 2h C peptide(2h CP), insulin resistance index calculation two groups(HOMA-IR)of two groups were comparated. The quality of life of patients of Preoperative and postoperative 6 months were evaluated with Quality of Life(QOL)scale. Results: The levels of BMI, FPG, Hb A1 c, FINS, FCP, 2h FPG, 2h INS, 2h CP of control group before pre-surgery were lower than observation group(P>0.05). The levels of FPG, Hb A1 c, 2h FPG, HOMA-IR of observation group after six months were significantly lower than before surgery, and the levels of FINS, FCP, 2h INS,2h CP after six months were higher than before surgery(P<0.05). The appetite, sleep, self-care ability, mental ability, disease awareness and overall quality of life scores of observation group were higher than control group, the difference was statistically significant(P<0.05). Conclusion:Roux-en-Y gastric anastomosis can improve islet β cells in patients with combined T2 DM function, lower blood sugar levels, improve the quality of life of patients.更多还原