非重度肥胖2型糖尿病的外科治疗（附200例报告）  

Surgical treatment of non-severe obesity with type 2 diabetes mellitus （a report of 200 cases）

作　　者：吴良平[1] 戴晓江[1] 张玉新[1] 屠伟峰[2] 邱小文[3] 康慧鑫[1] 黄永滔[1] 张红兵[1] 李婷婷[1] 

机构地区：[1]广州军区广州总医院甲状腺、糖尿病外科中心,广州510010 [2]广州军区广州总医院麻醉科,广州510010 [3]广州军区广州总医院营养科,广州510010

出　　处：《腹部外科》2013年第5期298-301,共4页Journal of Abdominal Surgery

基　　金：广东省科技计划项目（2010B060900068）

摘　　要：目的 探讨全腹腔镜胃旁路术（laparoscopic gastric bypass surgery,LGBP）治疗非重度肥胖2型糖尿病（type 2 diabetes mellitus,T2DM）的临床疗效.方法 2009年7月至2012年5月实施LGBP的200例非重度肥胖T2DM[25 kg/m2≤术前体重指数（BMI）＜35 kg/m2]患者,监测其术前、术后的空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹C肽,并进行统计学分析.结果 LGBP术后1年空腹血糖由术前的（8.95±0.52） mmol/L降为（6.01±0.31） mmol/L,餐后2 h血糖由术前的（15.55±1.30） mmol/L降为（9.02±0.61） mmol/L,糖化血红蛋白由术前的（8.23±0.37）%降为（5.35±0.45）%,三者均有不同程度的下降,差异均有统计学意义（P值均＜0.05）.而餐后血糖下降比空腹血糖快、显著,空腹C肽水平变化不明显.结论 LGBP治疗非重度肥胖T2DM近期疗效明显,术后餐后血糖、空腹血糖的改善不同步,预示其机制可能不完全相同.LGBP是一种微创、安全、有效的外科治疗糖尿病的方法,其远期疗效有待于进一步随访.Objective To evaluate the clinical ef}ects of laparoscopic gastric bypass surgery （I.GBP） on non-severe obesity with 2 diabetes mellitus. Methods Totally 200 patients with nowse- vere obesity with T2DM （25 kg/m2~Preoperative BMI^35 kg/m2 ） who took fully implementation of the gastric bypass surgery from July 2009 to May 2012 were enrolled. Indicators including fasting and postprandial blood glucose （2 h）, glycated hemoglobin, peptide C, insulin and body mass index （BMI） were analyzed preoperatively and postoperatively. Results For all of the patients, the levels of fasting and postprandial blood glucose （2 h）, and glycated hemoglobin were decreased to varying de- grees one year after operation. The declining degree of postprandial blood glucose （2 h） was more sig- nificant than fasting glucose. There was no obvious changes in levels of fasting peptide C. Conclusion The short term therapeutic effectiveness of LGBP on non-severe obesity with T2DM is obvious. The postoperative improvement of fasting and postprandial blood glucose （2 h） is asynchronous, indicating their mechanisms may be different. With the advantages of minimal invasion, safety and short-term ef- fectiveness, LGBP is a satisfactory treatment method for T2DM.

关 键 词：胃旁路术 糖尿病 2型 非重度肥胖 

分 类 号：R587.1[医药卫生—内分泌]