中国实用外科杂志

中国实用外科杂志

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胃癌合并2型糖尿病病人术后糖尿病改善相关因素分析

庞    涛1，秦婴逸2，史    征1，郑    瑞1，申晓军1，聂明明1，薛绪潮1，毕建威1，印    慨1   

  1. 1第二军医大学附属长海医院胃肠外科，上海200433；2 第二军医大学统计教研室，上海200433
  • 出版日期:2017-02-01 发布日期:2017-01-24

  • Online:2017-02-01 Published:2017-01-24

摘要：

目的    探讨影响胃癌合并2型糖尿病（T2DM）病人术后糖尿病改善的相关因素。方法    回顾性分析2013年1月至2016年7月第二军医大学附属长海医院162例胃癌合并T2DM病人临床及随访资料，包括性别、年龄、糖尿病病程、随访术后血糖变化及用药情况，肿瘤大小、分型、分期、浸润深度、淋巴转移情况，以及胃癌根治手术不同手术方式治疗（Bypass-：Billroth Ⅰ式吻合、近端胃切除；Bypass+：全胃或远端胃切除+Roux-en-Y吻合），采用CMH及秩和检验进行单因素分析，并对相关因素进行logistic回归分析。结果    胃癌合并T2DM病人术后效果与病人年龄、肿瘤大小、手术方式及病程长短存在明显相关性。而与病人性别、术后血糖变化及用药情况、肿瘤分型、分期、浸润深度、淋巴转移情况指数无明显相关性。结论    对于胃癌合并T2DM病人，Bypass+有助于改善胃癌术后病人血糖，特别是T2DM病程较短、年龄较小、肿瘤较小病人，以此提高术后短期内糖尿病改善。

关键词: 胃癌, 2型糖尿病, 手术治疗

Abstract:

Analysis of related factors for improvement of postoperative diabetes in gastric cancer patients with type 2 diabetes mellitus:A report of 162 patients        PANG Tao*, QIN Yin-yi, SHI Zheng, et al. *Department of Gastrointestinal Surgery, Changhai Hospital, the Second Military Medical Univeristy of PLA, Shanghai 200433, China
Corresponding author: YIN Kai,E-mail:kyin67@126.com
Abstract    Objective    To investigate the improvment fators for patients of type 2 diabetes mellitus(T2DM) with gastric cancer after surgery. Methods    The clinical data of 162 patients of gastric cancer associated with type 2 diabetes admitted from January 2013 to July 2016 in Department of Gastrointestinal Surgery, Changhai Hospital were collected, including gender, age, duration of diabetes, glucose, used drug and the remission of diabetes after different gastric cancer surgery (Bypass-：Billroth-I，Proximal gastrectomy；Bypass+：Total，Distal gastrectomy+ Roux-en-Y anastomosis ). One-way analysis of CMH rank-sum test was used, and logistic regression analysis was performed on the multiple factor. Results    The postoperative results of patients with gastric carcinoma with T2DM were significantly correlated with the following factors：age, type of surgery, tumor size and duration of T2DM, but not gender, glucose, used drug, tumor type, stage, depth of invasion, lymphatic metastasis. Conclusion    For gastric cancer patients with T2DM, bypass+ help improve diabetes postoperatively, especially for T2DM short duration, smaller tumor and younger patients.

Key words: gastric cancer, type 2 diabetes mellitus, surgical treatment