腹腔镜袖状胃切除术对肥胖相关疾病的治疗分析  

Efficacy analysis of laparoscopic sleeve gastrectomy in the treatment of obesity-related comorbidities

作　　者：沈迪建[1] 叶环[2] 王跃东[1] 季赟[1] 谢志杰[3] 吴嘉[3] 占小莉[1] 朱锦辉[1] 

机构地区：[1]浙江大学医学院附属第二医院普通外科,杭州310009 [2]杭州师范大学附属医院外科 [3]浙江省人民医院外科

出　　处：《中华胃肠外科杂志》2012年第11期1139-1141,共3页Chinese Journal of Gastrointestinal Surgery

基　　金：卫生部科学研究基金--浙江省医药卫生重大科技计划立项课题（WKJ201-2-013）

摘　　要：目的探讨腹腔镜袖状胃切除术（LSG）治疗肥胖症及肥胖相关疾病的安全性和有效性。方法回顾性分析2006年12月至2011年7月间在浙江省人民医院接受LSG术的67例肥胖症患者的临床资料。观察术后1年患者体质量指数（BMI）、多余体质量减少率（EWL）以及2型糖尿病、高血压等肥胖相关疾病的改善情况。结果67例患者均顺利完成LSG术。手术时间（78±17）min．术后住院时间（5．0±1．7）d。术后恢复均顺利,无围手术期死亡及术后严重并发症发生。64例（95．5％）患者获得术后1年的随访，BMI由术前的（37．7±4．1）kg／m2下降了（10．4±3．7）kg／m2，EWL为（80．2±27．7）％。2型糖尿病和高血压的治愈率分别为53．8％（7／13）和45．5％（5／11）,缓解率均达100％。高三酰甘油血症（51例）、高尿酸血症（42例）、睡眠呼吸暂停综合征（2例）、骨关节疾病（9例）和棘皮病（8例）等其他肥胖相关疾病也得到治愈或不同程度的改善。结论LSG治疗肥胖症是安全可行的。在明显减轻体质量的同时还能治愈或改善2型糖尿病和高血压等肥胖相关疾病。Objective To investigate the safety and efficacy of laparoscopic sleeve gastrectomy （LSG） for the treatment of obesity and related diseases. Methods Clinical data of 67 patients who underwent LSG between December 2006 and July 2011 were analyzed retrospectively. Improvements in body mass index （BMI）, percentage of excess weight loss （EWL）, type 2 diabetes mellitus, hypertension and other comorbidities were observed at one year postoperatively. Results Laparoscopic procedures were completed in 67 patients without conversion. The operative time was （78±17） rain. The postoperative hospital stay was（5.0±1.7） d. The postoperative recovery was uneventful and there were no perioperative death or severe postoperative complication. Sixty-four patients（95.5% ） had a postoperative follow up of 1 year. One year after LSG, BMI decreased by（10.4±3.7） kg/m2 from （37.7±4.1） kg/m2 preoperatively and EWL was （80.2±27.7）%. In 13 eases of type 2 diabetes mellitus, 7 patients （53.8%, 7/13） were weaned off hypoglyeemic agents or insulin. In 11 cases of hypertension, 5 required no medications （45.5%, 5/11）. The remission rate was both 100%. There was significant resolution or improvement of other obesity-related comorbidiities, including hyper-triglyceridemia（n=51 ）, hyperuricemia（n=42）, sleep apnea syndrome （n=2）, osteoartieular disease （n=9）, and acanthosis （n=8）. Conclusions LSG is safe and feasible for the treatment of obesity and can cure or improve type 2 diabetes mellitus, hypertension and other obesity related comorbidities.

关 键 词：肥胖症 肥胖相关疾病 袖状胃切除术 腹腔镜 治疗效果 

分 类 号：R656.6[医药卫生—外科学]