胃转流术对非肥胖型2型糖尿病的治疗作用
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王烈

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The therapeutic effect of gastric bypass operation on non-obese type 2 diabetes
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    摘要:

    目的:观察胃转流术对非肥胖型2型糖尿病的治疗作用。
    方法:回顾性分析5年余行胃转流术治疗的胃癌伴非肥胖型2型糖尿病患者103例的临床资料,包括手术前后体重指数(BMI)、空腹血糖水平、胰岛素抵抗指数、糖化血红蛋白的变化情况及术后6个月糖尿病转归情况。
    结果:全组患者术后BMI较术前无明显变化(P>0.05); 而从术后1周开始空腹血糖水平即出现持续而稳定下降的趋势(P<0.05); 伴随着术后血糖水平的改善,胰岛素抵抗指数、糖化血红蛋白亦出现明显下降(P<0.05)。术后6个月,糖尿病总治愈率为79.6%; 而不同的胃转流术式(食管-空肠Roux-en-Y术和莫氏法胃空肠吻合术)对糖尿病的控制无统计学差异(P>0.05)。
    结论:胃转流术对非肥胖型2型糖尿病具有较好的治疗作用; 其对2型糖尿病的控制不依赖于体重的降低。

    Abstract:

    Abstract:Objective:To observe the therapeutic effect of gastric bypass operation on non-obese type 2 diabetes.
    Methods :Retrospective analysis the clinical data of 103 non-obese patients with type 2 diabetes underwent gastric bypass operation in our hospital during the last five years, including the body mass index,the fasting blood glucose level,the insulin resistance index,the changes in glycosylated hemoglobin before and after surgery, and the turnover of the diabetes condition six months after surgery.
    Results:Postoperatively, comparing to before operation, there was no significant difference in body mass index (P>0.05); one week after surgery,the fasting blood glucose level showed a sustained and steady downward trend (P<0.05). With the decrease of the fasting blood glucose,the insulin resistance index and glycosylated hemoglobin also decreased significantly (P<0.05). Diabetes cure rate was 79.6 percent overall six months later,and there was no significant difference in the control of diabetes between the different types of gastric bypass operation:esophago-jejunum Roux-en-Y surgery and Mo′s gastro-jejunum anastomosis(P>0.05).
    Conclusions:Gastric bypass operation has a good therapeutic effect on type 2 diabetes in the non-obese patients, and this therapeutic effect is not dependent on loss of body weight.

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王瑜, 王燕婷, 王烈.胃转流术对非肥胖型2型糖尿病的治疗作用[J].中国普通外科杂志,2008,17(10):14-100.
DOI:10.7659/j. issn.1005-6947.2008.10.014

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  • 在线发布日期: 2008-10-25