Effect Of Four Kinds Of Gastrointestinal Tract Reconstruction On Postoperative Glycometabolis In Gastric Cancer Patients Complicated With Type 2 Diabetes

Object:To discuss the effec of four kinds of gastrointestinal tract reconstruction on postoperative glycometabolism in gastric cancer patients complicated with type 2diabetes mellitus.Methods :sixty gastric cancer patients with type 2 diabetes who received underwent gastrectomy in the department of general surgery of the first affiliated hospital of Wan nan Medical Collage were retrospectively analyzed from March 2014 to March 2015.The patients were grouped into Billroth ?(Group A,n=15),Billroth ?(Group B,n=15),Total gastrectomy with Roux-en-Y group(Group C,n=15).and proximal subtotal group(Group D,n=15).After surgeries follow up all the patients for more than one year,and collect the postoperative clinical data of fasting blood glucose(FPG),2hour blood glucose(2h PG)after meal,fasting insulin(FINS),C-peptid(FC-P),glycosylated hemoglobin(Hb A1c)and the index of insulin resistance(IR)in three month,six month and one year.To discuss the effec of four different rebuild on glucose metabolism inpatients with gastric cancer comp licated with type 2 diabetesmellitus(T2DM).The data was statistical analyzed with the spss13.0.We ruled P<0.05 was considered statistical difference is significant.Results: The group of Billroth I gastrectomy,Billroth ? gastrectomy,Total gastrectomy with Roux-en-Y and proximal subtotal group each index of fasting blood glucose(FPG),2hour blood glucose(2h PG)after meal,fasting insulin(FINS),fasting C-peptid(FC-P),glycosylated hemoglobin(Hb A1c)and the index of insulin resistance(IR)has obvious change after three months,six months and one year of postoperative is much better than preoperative effect.The group of Total gastrectomy with Roux-en-Y group each index of fasting blood glucose(FPG),2hour blood glucose(2h PG)after meal,fasting insulin(FINS),C-peptid(FC-P),glycosylated hemoglobin(Hb A1c)is much better than the group of Billroth I gastrectomy and proximal subtotal group.The group of Billroth ? gastrectomy each index of fasting blood glucose(FPG),2hour blood glucose(2h PG)after meal,fasting insulin(FINS),C-peptid(FC-P),glycosylated hemoglobin(Hb A1c)is much better than the group of Billroth I gastrectomy and proximal subtotal group postoperative 6 and 12 months.In addition the study of four groups of diabetic patients after improved efficiency by comparing the results show: there are significant differences in the treatment of total gastrectomy Roux-en-Y with Billroth ?(c 2 = 8.889,P <0.05),and there are also significant differences in terms of therapeutic efficacy with proximal gastrectomy(c2=7.003,P <0.05).There are significant differences in the treatment of Billroth ? with Billroth?(c2 = 4.821,P <0.05),therefore there is a significant difference in terms of treatment.Conclusion: 1.Billroth?,Billroth?,total gastrectomy Roux-en-Y and proximal gastrectomy after surgical resection of the index and preoperative examination comparative indicators have improved significantly.2.Billroth ?,Total gastrectomy with Roux-en-Y group both gastric reconstruction for the index and preoperative examination after surgical resection improved much better than Billroth?and proximal gastrectomy.3.Billroth?,Total gastrectomy with Roux-en-Y group were the better choice in gastric cancer patients complicated with type 2 diabetes mellitus.