Roux-en-Y 胃肠道重建术在胃癌伴2型糖尿病治疗中应用及其对胰岛功能的影响

目的：探讨 Roux-en-Y 胃肠道重建术治疗胃癌合并2型糖尿病的临床疗效，并分析患者胰岛功能的变化。方法：收集我院与南京市第一医院2010年1月~2016年6月间的100例胃癌合并2型糖尿病患者作为研究对象，依据随机数字表法分为研究组与对照组，各50例。对照组常规胃食管吻合手术治疗，研究组 Roux-en-Y 胃肠道重建术治疗，对两组患者临床治疗效果与胰岛素功能变化进行观察。结果：手术后研究与对照两组患者糖化血红蛋白、空腹血糖、餐后2h 血糖、空腹 C 肽、空腹胰岛素、餐后2h 空腹 C 肽、餐后2h 空腹胰岛素和胰岛素抵抗指数均较手术前显著改善，且研究组优于对照组，差异有统计学意义。研究组患者术后近期并发症发生率4.0%，明显的低于对照组14.0%，差异有统计学意义。结论：临床中对于胃癌合并2型糖尿病患者应用 Roux-en-Y 胃肠道重建术治疗效果显著，在改善胰岛功能有明显的作用，更好的控制血糖水平，值得临床中应用。

Its application in the treatment of diabetes type 2 islet function Roux-en-Y gastric cancer in the gastrointestinal tract reconstruction with

Objective Roux-en-Y gastric gastrointestinal reconstruction in the treatment of type 2 diabetes combined clinical efficacy, and to analyze changes in the patient islet function. Methods 100 cases of gastric cancer hospital in January 2010 to December 2015 among patients with type 2 diabetes as an object of study, based on randomly divided into study group and control group, 50 cases in each. The control group of conventional anastomosis surgical treatment of gastroesophageal study group Roux-en-Y gastrointestinal reconstruction in the treatment of clinical treatment with insulin function in the two groups were observed. Results After surgery study and the control groups were glycated hemoglobin, fasting blood glucose, postpran-dial 2h glucose, fasting C-peptide, fasting insulin, postprandial 2h fasting C-peptide, postprandial 2h before fasting insulin and insulin resistance index significantly compared with surgery improved, and the study group than the control group, the differ-ence was statistically significant. Study patients postoperative complication rate was 4.0%, significantly lower than 14.0% in the control group, the difference was statistically significant . Conclusion The clinical application for patients with type 2 gastric Roux-en-Y gastrointestinal reconstruction diabetes treatment significantly improve islet function has significant effects, better control of blood sugar levels, is worthy of clinical application.