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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。
Objective To observe the therapeutic effect of gastric bypass on non-obese type 2 diabetes mellitus. Methods The clinical data of 103 patients with gastric cancer with non-obese type 2 diabetes mellitus treated by gastric bypass after 5 years were retrospectively analyzed. The changes of body mass index (BMI), fasting blood glucose, insulin resistance index, glycosylated hemoglobin Situation and 6 months after the outcome of diabetes. Results The postoperative BMI in all patients showed no significant change (P> 0.05), while the fasting blood glucose level decreased continuously and steadily from the first week after operation (P <0.05). With the postoperative blood glucose level Improvement, insulin resistance index, glycosylated hemoglobin also showed a significant decline (P <0.05). Six months after surgery, the overall cure rate of diabetes was 79.6%. There was no significant difference in the control of diabetes between different gastric bypass procedures (esophageal-jejunal Roux-en-Y and Morse jejunal anastomosis) P> 0.05). Conclusion Gastric bypass has a good therapeutic effect on non-obese type 2 diabetes. Its control of type 2 diabetes does not depend on the decrease of body weight.