2 型糖尿病胃肠转流术后早期肠内营养对血糖的影响

目的：探讨2 型糖尿病Roux-en-Y 胃肠转流术（RYGBP）后早期肠内营养对患者血糖的影响。方法：回顾2011 年7 月至 2012 年7 月我科63 例不同发病年龄、不同病程的2 型糖尿病患者行Roux-en-Y 胃肠转流术（RYGBP）后的恢复情况。共分两组： A 组为术后完全肠外营养直至胃肠道功能恢复正常的患者；B 组为术后早期开始肠内营养患者。监测两组患者术后3 天至2 周的 血清白蛋白含量、血脂、肠蠕动恢复时间、血糖水平、C 肽水平。结果：A、B 两组术后血清白蛋白含量及血脂水平无显著性差异。B 组患者肠功能恢复时间少于A组，血糖水平下降时间较A 组快，其血糖下降时间与肠功能恢复时间一致，B组血清C肽水平变 化时间较A 组提前。结论：2 型糖尿病胃肠转流术（RYGBP）后早期肠内营养支持可以促进肠道功能恢复，加快血糖水平下降，改 善胰岛调节功能。

The Effect of Early Enteral Nutrion on Blood Glucose in Type 2 Diabetes Patients after RYGBP

Objective:To investigate the effect of early enteral nutrion on blood glucose in type 2 diabetes patients who accepted the surgery of Roux-en-Y gastrointestinal bypass postoperative (RYGBP).Methods:To review the recovery of 63 patients with type 2 diabetes after they received the surgery of RYGBP, from july 2011-july 2012. All patients were divided into two groups: patients in Group A were given total parenteral nutrion until their gastrointestinal funtion recoveied normal; Patients in Group B were given early enteral nutrion. And the level of serum albumin and blood lipids, peristalsis recovery time, the level of blood glucose and C-peptide were detected.Results:The level of serum albumin and blood lipids had no significent difference in group A and group B. The peristalsis recovery time of group B was less than group A, and the level of blood glucose of group B drop faster than that in group A. The time of blood glucose dropped keep consistent with the time of peristalsis recovery. The time of C-peptide change in group B was ahead of group A.Conclusion:Early enteral nutrion after RYGBP in patients with type 2 diabetes can promote recovery of intestinal function, accelerate the decline of glucose level, and improve the adjustment function of islet.