全腹腔镜胃转流术治疗肥胖型和非肥胖型2型糖尿病的疗效分析  

Clinical Analysis on the Effect of Gastric Bypass Operation on Obese and Non-obese Type 2 Diabetes

作　　者：高羽[1] 童卫东[1] 刘宝华[1] 张安平[1] 李凡[1] 李春穴[1] 王李[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所胃结直肠肛门外科,重庆400042

出　　处：《河北医学》2012年第9期1191-1194,共4页Hebei Medicine

摘　　要：目的:研究胃转流术(GBP)治疗肥胖型和非肥胖型2型糖尿病的疗效及其疗效差异。方法:回顾分析我院2010年采用GBP治疗的肥胖型和非肥胖型2型糖尿病患者各34例的临床资料,包括术前与术后的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc)、空腹胰岛素(Fins)和胰岛素抵抗指数(HOMA-IR)的变化情况和疗效评定,并比较其疗效差异。结果:68例手术均成功,两组患者术前Fins和HOMA-IR的组间差异有统计学意义(P<0.05),肥胖型组均较高,其余各项指标的组间差异均无统计学意义(P>0.05),术后6个月,两组患者除Fins的变化差异无统计学意义(P>0.05),各指标均有不同程度的下降,与术前相比差异均有统计学意义(P<0.05),两组患者术后的组间差异与术前相同,两组手术有效率均大于94%,治愈率均大于85%。结论:GBP对肥胖型与非肥胖型T2DM均有显著疗效,其治疗机制与摄食减少导致低热量和体重减轻无关。Objective： To study the clinical effect of gastric bypass operation on obese and non-obese type 2 diabetes mellitus （ T2DM ） , and compare the differences. Method： The clinical data of 34 obese pa-tients and 34 non-obese patients with type 2 diabetes underwent gastric bypass operation in our hospital in 2010 were retrospectively analyzed. The fasting plasms glucose（FPG） and 2-hour postprandial plasms glueose（2hPG） level, glycated hemoglobin（HbAlc） and fasting insulin（Fins） were dynamically monitored before and after surgery, and the insulin resistance index（HOMA-IR） was calculated. The clinical effects on the different groups of type 2 diabetes were evaluated and compared. Result： 68 cases were performed successfully. The Fins and HOMA-IR of obese patients group were significant higher than those of non-obese patients group（ P〈0. 05 ） before surgery, while there were no significant differences on the level of FPG, 2hPG and HbAlc between the two groups（P〉0.05） before surgery. The level of FPG ,2hPG, HbAlc and HOMA-IR showed a significant decreasing trend six months after surgery when compared to those before surgery （P〈0.05） ,while there was no significant change of the Fins after surgery（ P〉0. 05）. The differences of all the index between the two groups after surgery were same to those before surgery. The effective rate of the two groups were all more than 94%, and the clinical complete response rate of them were all more than 85%. Conclusion： Gastric bypass surgery has a good effect on both obese patients and non-obese patients with type 2 diabetes mellitus, and the therapeutic effect has no relation with less ingestion for intaking fewer calory and loss of body weight.

关 键 词：胃转流术 2型糖尿病 肥胖型 非肥胖型 

分 类 号：R587.1[医药卫生—内分泌]