腹腔镜下胃旁路术治疗非肥胖2型糖尿病的临床疗效观察  

Effect of Laparoscopic Roux-en-Y Gastric Bypass in non-obese patients with type 2 diabetes mellitus

作　　者：张向文[1] 梁怀祝[1] 赵国华[1] 张海涛[1] 

机构地区：[1]大连市中心医院普外二科,116033

出　　处：《中国实用医药》2014年第14期17-18,共2页China Practical Medicine

摘　　要：目的观察腹腔镜下胃旁路术（LRYGB）对非肥胖2型糖尿病患者临床疗效。方法对2011年1月-2012年10月间本院实施LRYGB的2型糖尿病病患者中BMI〈28.0 kg/m216例患者的临床资料进行回顾性分析。结果平均手术时间145 min,术中平均出血量35 ml,术后平均9.3 d,术后出现吻合口出血1例,无死亡病例及严重的手术并发症。术后患者1个月空腹血糖及餐后血糖明显下降（P〈0.01）,术后3个月至半年降至正常水平。糖化血红蛋白在术后3个月开始明显下降（P〈0.01）,术后半年降至正常水平。体质量指数在术后1个月有明显下降,术后6个月-12个月期间体质量指数趋于稳定,无明显变化。结论 LRYGB后2型糖尿病患者血糖代谢明显改善,但其远期疗效还需进一步研究。ObjectiveTo evaluate the efficacy of Laparoscopic Roux-en-Y Gastric Bypass（LRYGB） in non-obese patients with type 2 diabetes mellitus.MethodsLRYGB was performed in 16 T2DM patients with BMI〈28 kg/m2 in our hospital from January 2011 to October 2012. Preoperative date including BMI, fasting plasma glucose, 2 h postprandial glucose and glycosylated hemoglobin were compared with the date collected at 1,3,6 and 12 postoperative months.ResultsThe mean operative time was 145 min, the mean bleeding was 35 ml, and the mean postoperative time was 9.3 days. Anastomosis bleeding occurred in 1 case. There were no mortality and significant surgical complications occurred. Both fasting plasma glucose and 2 h postprandial glucose were significantly decreased at 1 month after operation, and the changes were lasted for 12 month. Significant reduction in glycosylated hemoglobin from 3 months after operation was observed. Glycosylated hemoglobin dropped to normal level from 6 months post-operation. BMI obviously decreased after 1 month, and there was no drop from 6 month comparing with 12 month after operation.ConclusionLRYGB is an effective treatment to non-obese patients with type 2 diabetes mellitus. It has long-term efficacy and needs further research.

关 键 词：2型糖尿病 胃旁路术 腹腔镜 

分 类 号：R587.1[医药卫生—内分泌]