Three Kinds Of Digestive Tract Reconstruction Surgery On Distal Gastric Cancer Combined Research Of Glucose Metabolism Of Patients With Type 2 Diabetes

Background:Gastric cancer is the most common surgical disease, and diabetes mellitus is refractory disease common in department of internal medicine, the interdisciplinary possibility is larger, however many clinical workers did not fully understand the inner relationship between, often simply from the professional point of view the treatment plan, and no comprehensive treatment norms, affect the overall effect.Objective:To investigate the effect and clinical significance of serum glucose changes in type 2 diabetic patients with gastric cancer treated by digestive tract reconstruction operation.Methods:Retrospective analysis of 80 cases clinical data of the gastric cancer patients with type 2 diabetes treated in the department of general surgery in our hospital during 2011 June to 2013 June, according to different operation methods patients were divided into 3 groups, group I (using Billroth I anastomosis 15 cases), group â…¡ (using Billroth II anastomosis 36 cases, group III (using Roux-en-Y anastomosis 29 cases). The changes of blood glucose, body mass index (BMI),fasting blood glucose (FPG), fasting insulin resistance index (FINS), Homeostasis model assessment insulin resistance index, HOMA-IR) and Homa insulin beta cell function index(HOMA-HBCI) of three different groups were compared before surgery and after surgery at 1 months,3 months,6 months.Results:After six months of collecting patients clinical data, no tumor recurrence, and other factors significantly affect blood sugar:three groups of patients after 1 months,3 months,6 months of surgery in the BMI were lower than that before operation (P< 0.05). Group â…  after 1 months,3 months of surgery FPG, FINS, HOMA-IR were significantly decreased, HOMA-HBCI was significantly increased (P<0.05), but after 6 months of surgery FPG, FINS, HOMA-IR were no significant difference (P> 0.05). Group â…¡, â…¢ after 1 months,3 months,6 months of surgery FPG, FINS, HOMA-IR were significantly decreased, HOMA-HBCI was significantly increased (P< 0.05), but three time points at 1 months,3 months,6 months,were no significant difference (P> 0.05). Comparison between groups:in group â…¡,â…¢ after 3 months,6 months of surgery FPG, FINS, HOMA-IR were lower than group â…  (P< 0.05),HOMA-HBCI were higher than those in group â… (P< 0.05). Group â…¡, â…¢ after 1 months,3 months,6 months of surgery FPG, FINS, HOMA-IR and HOMA-HBCI were no significant difference (P> 0.05). Group â…¡, â…¢ total effectiveness had no obvious difference, but were higher than those in group â…  (P<0.05).Conclusions:operation can make the distal gastric carcinoma patients with diabetes mellitus blood sugar under control; Billroth â…  digestive tract reconstruction surgery in the near future (<6 months) to keep blood sugar under control effect is good, the long-term (> 6 months) effect is not as good as Billroth â…¡ and Roux en-Y two digestive tract reconstruction operation control blood sugar effect is good. Therefore, gastric cancer patients with type2 diabetes choose Billroth â…¡ or Roux-en-Y operation can be effectively improve the prognosis of gastric cancer and quality of life.