摘要
目的探讨胃转流手术治疗2型糖尿病的临床效果及管理现状分析。方法按体质指数（BMI）不同将行胃转流手术的57例2型糖尿病患者分为4组，A组BMI〈20kg／m^2 8例、B组20kg/m^2≤BMI〈24kg／m221例、C组24kg／m^2≤BMI〈27kg／m^217例、D组BMI≥27kg／m^2 11例，从血糖、糖化血红蛋白控制情况，饮食、体重变化及糖尿病并发症、术后不良反应、术后管理等方面对患者进行随访或复查，并进行综合分析。结果C组的治愈率[70．6％（12／17）]最高，A组的治愈率（0）最低，总治愈率43．9％（25／57），总好转率28．1％（16／57），总有效率71．9％（41／57），总无效率28．1％（16／57）。除少数患者出院后有营养不良、闭经、肠胃功能不好、腹泻、饮食差等外，其余患者术后均未遗留手术并发症，无一例患者死亡。术后无医护人员定期跟踪、随访、宣教。结论胃转流手术可安全有效治疗肥胖及非肥胖的2型糖尿病，是当前治疗糖尿病的一种新方法，但一定要掌握好适应证，避免手术扩大化，术后要完善从内外科医师到营养师、护理团队的管理。
Objective To investigate the clinical effect of gastric bypass operation on treating type 2 diabetes, and analyze the management status. Methods Fifty-seven patients with type 2 diabetes treated by gastric bypass operation were divided by different body mass index（BMI） into 4 groups： group A（BMI 〈 20 kg/m2） with 8 cases,group B （20 kg/m^2 ≤BMI 〈 24 kg/m^2） with 21 cases,group C （24 kg/m≤BMI 〈 27 kg/m^2） with 17 cases and group D （BMI ≥27 kg/m^2） with 11 cases. The control of blood glucose and glycosylated hemoglobin, changes of diets and body weight, diabetes complications, adverse reactions after operation and postoperative management were followed up or reviewed. The clinical data were analyzed comprehensively. Results The cure rate of group C was the highest [ 70.6% （12/17）], while the cure rate of group A was the lowest （0）. The overall cure rate was 43.9%（25/57） and the overall improvement rate was 28.1% （16/57）. The overall efficient rate was 71.9% （41/57） and the overall inefficient rate was 28.1% （16/57）. Apart from a few patients had malnutrition,amenorrhea,bad stomach,diarrhea and poor diet after leaving the hospital, other patients had no surgery complications and no patients died. There was no clinician to follow up and did education to these patients after operation. Conclusions Gastric bypass operation is safe and effective for obese and non-obese patients with type 2 diabetes. It is a new method to treat type 2 diabetes at present, but the indications should be grasped and operation enlargement must be prevented. The management of teams of physicians, surgeons, dietitians, nurses should be established after operation.
出处
《中国医师进修杂志》
2012年第19期14-17,共4页
Chinese Journal of Postgraduates of Medicine
关键词
糖尿病
2型
胃转流手术
管理现状
Diabetes mellitus,type 2
Gastric bypass surgery
Administrative situation
