目的 对比毕Ⅰ式、毕Ⅱ式、Roux-en-y胃肠重建手术对2型糖尿病降糖效果。方法 检索中国生物医学文献数据库、中文生物医学期刊文献数据库、中国知网、维普、万方、MEDLINE,1994-01至2013-10发表的不同消化道重建手术对2型糖尿病疗效对比的文献,筛选、提取、质量评价,用RevMan5.0软件进行meta分析。结果 共有7篇文献入选,病例总数378例,毕Ⅰ式74例,毕Ⅱ式184例,Roux-en-y120例。meta分析结果:(1)毕Ⅰ式、毕Ⅱ式以及Roux-en-y术后3个月血糖水平均明显低于术前;(2)毕Ⅰ式与毕Ⅱ式术后3个月血糖水平无差别;(3)毕Ⅰ式术后3个月血糖水平明显高于Roux-en-y;(4)毕Ⅱ式与Roux-en-y术后3个月血糖水平无差别;(5)毕Ⅰ式术后6个月血糖水平明显高于毕Ⅱ式和Roux-en-y;(6)毕Ⅱ式与Roux-en-y相比术后6个月血糖水平无差别;(7)毕Ⅰ式术前与术后6个月血糖水平无差别;(8)毕Ⅱ式和Roux-en-y术后6个月血糖水平均明显低于术前;(9)毕Ⅱ式与Roux-en-y术后6个月糖尿病治疗有效率无差别。结论 毕Ⅱ式和Roux-en-y对2型糖尿病的治疗均有效。

Objective To compare the hypoglycemic effects of Billroth Ⅰ, Billroth Ⅱ, Roux-en-y gastrointestinal reconstruction operations on type 2 diabetes mellitus. Methods The literature(1994.01-2013.10)was searched about different digestive tract reconstruction operations published on the comparison of curative effect of type 2 diabetes mellitus in CBM, CMCC,CNKI, VIP, WANFANG, MEDLINE, then screened, extracted, quality was evaluated. Meta-analysis was performed by using RevMan5.0 software. Results A total of 7 articles were selected.The total numbers of cases in 378 cases,were 74 in Billroth Ⅰ, 184 in Billroth Ⅱ, and 120 in Roux-en-y. The Results of meta-analysis were as follows: (1) The blood glucose levels in Billroth Ⅰ, Billroth Ⅱ and Roux-en-y in the third month after operation were significantly lower than those preoperation. (2) No difference in blood glucose levels between Billroth Ⅰ and Billroth Ⅱ in the third month after operation. (3) The blood glucose levels in Billroth Ⅰ were significantly higher than those of Roux-en-y in the third month after operation. (4) No difference in blood glucose levels between Billroth Ⅱ and Roux-en-y in the third month after operation. (5) Half a year after operation ,the blood glucose level of Billroth I was significantly higher than that of Billroth Ⅱ and Roux-en-y.(6) Compared with Billroth Ⅱ and Roux-en-y, no difference in blood glucose levels after half a year of the operation.(7) Comparism of preoperation and six months after Billroth I operation, showed no difference in blood glucose.(8) The blood glucose levels of Billroth Ⅱ and Roux-en-y after half a year of the operation were significantly lower than that of the preoperation.(9) For Billroth Ⅱ compared with Roux-en-y, there were no differences in diabetes treatment results. Conclusions The Billroth Ⅱ and Roux-en-y operations for the treatment of type 2 diabetes mellitus are effective.