【摘要】：目的:探討胃大部切除術(shù)對2型糖尿病患者血糖的影響。方法:回顧分析2009年~2014年間就診于延安大學(xué)附屬醫(yī)院的99例合并糖尿病并進(jìn)行胃大部分切除手術(shù)患者的臨床資料,通過甄選后對45例臨床資料完整、生存期相對比較長、無并發(fā)癥并愿意配合采訪的患者進(jìn)行研究。根據(jù)患者術(shù)后血糖含量和控制血糖含量所需要的攝入量將患者分為緩解組和無效組,比較兩組患者在年齡、身高、體重、BMI等之間的差異,分析患者手術(shù)前和手術(shù)后的血糖變化情況、分析手術(shù)前和手術(shù)后所需血糖控制藥物的使用情況等,搜集相關(guān)的數(shù)據(jù),改變定量,通過統(tǒng)計(jì)學(xué)進(jìn)行分析變量之間的差異,從而分析出胃大部分切除術(shù)對2型糖尿病患者血糖的影響。結(jié)果:所納入的45例研究對象中:男34例,女11例,胃癌患者30例,其中緩解組29例,無效組16例;平均年齡為63.2歲(緩解組:61.4歲,無效組:67歲),平均患2型糖尿病年限為7.4年(緩解組:5.5年,無效組:10.7年);其中畢Ⅰ式25例,畢Ⅱ式20例。統(tǒng)計(jì)學(xué)分析發(fā)現(xiàn):兩組患者在性別、年齡、術(shù)式、BMI、基礎(chǔ)疾病等方面沒有顯著性關(guān)聯(lián),但是與緩解組相比,無效組患糖尿病年限更長(5.5y VS.10.7y,P0.05);與術(shù)前相比,術(shù)后1年緩解組的FBG沒有顯著變化(7.19mmol/L VS.7.23 mmol/L,P0.05)、2h PBG顯著降低(11.29mmol/L VS.8.46mmol/L,P0.05),而無效組的FBG顯著升高(7.96mmol/L VS.8.34 mmol/L,P0.05)、2h PBG無顯著變化(11.06mmol/L VS.10.48 mmol/L,P0.05),組間比較差異有統(tǒng)計(jì)學(xué)意義。同時(shí)與無效組相比,緩解組還顯著降低了胰島素使用量。結(jié)論:胃大部切除術(shù)對2型糖尿病患者的血糖具有一定的影響,但是此影響取決于患者的糖尿病年限。
[Abstract]:Objective: to investigate the effect of subtotal gastrectomy on blood glucose in patients with type 2 diabetes mellitus. Methods: the clinical data of 99 patients with diabetes mellitus and partial gastrectomy in affiliated Hospital of Yan'an University from 2009 to 2014 were retrospectively analyzed. After selection, 45 cases were selected and the clinical data were complete and the survival time was relatively long. Patients who had no complications and were willing to cooperate were studied. The patients were divided into remission group and ineffective group according to the blood glucose content after operation and the intake needed to control the blood glucose content. The differences between the two groups in age, height, weight, BMI, etc., were compared. We analyzed the changes of blood glucose before and after operation, analyzed the use of blood sugar control drugs before and after operation, collected the relevant data, changed the quantity, and analyzed the differences between variables by statistics. The effects of subtotal gastrectomy on blood glucose in patients with type 2 diabetes mellitus were analyzed. Results: among the 45 subjects, 34 males and 11 females, 30 patients with gastric cancer, 29 patients in remission group and 16 patients in ineffective group. The mean age was 63.2 years (remission group: 61.4 years old, ineffective group: 67 years), and the average age of type 2 diabetes mellitus was 7.4 years (remission group: 5.5 years, ineffective group: 10.7 years), of which 25 cases were type 鈪，

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