The Clinical Analysis Of Gasterectomy For Glucose Metabolism On Human

Objective: Analysis of gastric tumor patients with type2diabetes after gastrectomy changeindex of postoperative blood glucose and glycosylated hemoglobin, Explore the effects ofgastrectomy on glucose metabolism, so as to further explore the mechanism of the surgicaltreatment of diabetes and to provision of basic and clinical basis for this technology.Methods: Collected41cases of operative indication stomach tumors and associated with type2diabetes, who were treated in Gastrointestinal Surgery, Shenzhen People’s Hospital from June2010to February2012,Record general information and determination of preoperative fastingplasma glucose and glycosylated hemoglobin.In the open or laparoscopic case after gastrectomyaccording to anastomosis were randomly divided into three groups:Group A line distalgastrectomy underwent Billroth-I anastomosis;GroupB rows distal gastrectomy underwentBillroth-II anastomosis;GroupC rows total gastrectomy underwent Roux-en-Y anastomosis;Atthe same time,the patients who suffering from rectal cancer and associated with type2diabeteswere set to the control group (group D).Postoperative detection of the first three days, seven daysfasting glucose, and follow-up2months after a retest fasting plasma glucose and glycosylatedhemoglobin.Statistical data and record the postoperative pathology.Results: Postoperative of3days and7days of fasting blood glucose was no significantdifference（P>0.05).Two months later3postoperative fasting blood glucose and glycosylatedhemoglobin decreased the number of cases were:3cases of fasting plasma glucose in group A（25%）,3cases of glycosylated hemoglobin（25%）;1cases of fasting plasma glucose in groupB（5%）,5cases of glycosylated hemoglobin（33%）;Fasting glucose in group C no decline,6casesof glycosylated hemoglobin（43%),the postoperative blood glucose and glycosylated hemoglobinof the control group D have no cases dropped to normal range.Two months of postoperative A, B,C, D four groups fasting plasma glucose by the Fisher’s Exact the Test analysis of average were:（6.37±0.37）mmol/l、（6.48±0.21）mmol/l、（6.51±0.12）mmol/l、（6.85±0.24）mmol/l，thetest statistic results,X~2=5.464,P=0.002.That group A blood sugar dropped more than group B,group B than group C, and group C than group D,there was significant difference（P<0.05）.A, B,C, D four groups postoperative2months the glycosylated hemoglobin by che Fisher’s Exact the Test analysis of average were:（7.01±0.49)%;（6.91±0.18）%;（6.86±0.16）%;(7.08±0.32)%,thetest statistic results,X~2=2.127,P=0.018,that the decline in glycosylated hemoglobin C than groupB, group B than group A and group A than group D,there was significant difference（P<0.05）.Conclusions: The patients with2diabetes after Gastrectomy which the blood glucose andglycosylated hemoglobin have different levels of decline compared with the preoperative，GroupA fasting blood glucose decreased most,glycosylated hemoglobin of Group C decreased than A,B groups,the control group D had no decreased.Therefore,gastrectomy can be better controldiabetes of patients blood glucose and glycosylated hemoglobinin the near future.Differentsurgical gastrectomy need to be further observed the long-term control of blood sugar,Thetreatment of diabetes and the mechanism needs further research.