腹腔镜辅助下胃转流术对胃癌合并2型糖尿病患者血糖、血脂、血压的影响

目的:探讨腹腔镜辅助下胃转流术(Laparoscopic Roux-en-Y gastric bypass,LRYGB)对胃癌合并2型糖尿病(T2DM)患者血糖、血脂、血压的影响。方法:62例胃癌合并T2DM患者分为观察组(n=31)与对照组(n=31),观察组行LRYGB治疗,对照组行腹腔镜下BillrothⅡ术治疗,对比两组患者手术前后血糖、血脂、血压控制情况。结果:术后6个月与术前1 d比较,两组患者空腹血糖(FPG)、餐后2h血糖(2h PG)、糖化血红蛋白(Hb Alc)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)均显著降低,差异有统计学意义(P<0.05);术后6个月观察组上述指标均显著低于对照组,高密度脂蛋白(HDL)显著高于对照组(P<0.05);观察组术后6个月清晨、睡前及平均血压均显著低于治疗前1 d(P<0.05),对照组无明显变化(P>0.05),且术后6个月观察组清晨、睡前及平均血压均显著低于对照组(P<0.05)。结论:LRYGB用于胃癌合并2型糖尿病患者的治疗,能够有效控制血糖,同时改善血脂代谢,降低血压,疗效确切,值得推广。

Influence on blood glucose,blood lipid and blood pressure of laparoscopic Roux-en-Y gastric bypass in gastric cancer patients complicated with type 2 diabetes mellitus

Objective:To discuss the influence of laparoscopic Roux-en-Y gastric bypass(LRYGB)in the treatment of gastric cancer patients complicated with T2DM on blood glucose,blood lipid and blood pressure.Methods:62 gastric cancer patients complicated with T2DM were randomly divided into the observation group(n=31)and the control group(n=31),the observation group were treated with LRYGB,and the control group were treated with laparoscopic BillrothⅡgastric bypass surgery.The blood glucose,blood lipid and blood pressure were contrasted between the two groups.Results:In the two groups,FPG,2 h PG,HbAlc 6 months after the surgery were significantly lower than these 1 day before the surgery(P<0.05),and the above indexes in observation group were significantly lower than these in the control group 6 months after the surgery(P<0.05);TG,TC,LDL in the two groups 6 months after the surgery were signifi-cantly lower than these 1day before the surgery(P<0.05);and TG,TC,LDL in the observation group significantly lower,HDL significant-ly higher than the one in the control group 6 months after the surgery(P<0.05);Morning,bedtime,average blood pressure in the observa-tion group 6 months after the surgery were significantly lower than these 1 day before the surgery(P<0.05),but no significantly differ-ence in the control group(P>0.05),and morning,bedtime,average blood pressure in the observation group significantly lower than these in the control group 6 months after the surgery(P<0.05).Conclusion:LYRGB can effectively control the blood glucose,improve blood lipid metabolism,and reduce the blood pressure in the treatment of gastric cancer patients complicated with T2DM,it has definite curative effect,and it’s worthy of promotion.