腹腔镜胃旁路手术治疗2型糖尿病的疗效及对患者生活质量的影响  

The therapeutic effect of laparoscopic Roux-en-Y gastric bypass(LRYGB)on type 2 diabetes mellitus and on the patients' life quality

作　　者：殷骏[1] 穆丽茜[1] 彭成娟 徐露[1] 毛忠琦[1] 周晓俊[1] 朱政[1] 陈昕[1] 孙洁[1] 钱海鑫[1] 

机构地区：[1]苏州大学附属第一医院腹腔镜微创外科,215006

出　　处：《中国糖尿病杂志》2014年第8期725-727,共3页Chinese Journal of Diabetes

基　　金：江苏省研究生科研创新计划资助项目(SCXZZ12_0846)

摘　　要：目的观察腹腔镜胃旁路手术治疗T2DM的疗效及对患者生活质量的影响。方法回顾性分析腹腔镜下胃旁路手术治疗T2DM患者的临床资料。术后随访,监测BMI、FPG、HbA1c、血脂、C-P等指标及T2DM相关并发症情况。运用生活质量调查表(SF-36)分析术后生活质量。结果 68例中,46例(67.6%)术后仅用生活方式治疗HbA1c≤6.5%,FPG≤7.0mmol/L,2hPG≤10.0mmol/L;18例(26.5%)口服降糖药或皮下注射胰岛素量较术前减少,血糖控制良好,FPG降幅>1.39mmol/L,HbA1c降幅>1%。术后1年糖尿病并发症改善27例,其中合并高血压14例(53.8%)、高脂血症15例(71.4%)、视力减退或合并DR 3例(21.4%)、尿蛋白阳性7例(41.2%)、糖尿病足(DF)或DPN 3例(27.3%)。SF-36量表对手术前及手术后1年的生理健康和精神健康调查统计分析显示,术后患者生理机能、生理职能、一般健康状况、精力、精神健康、社会功能及情感职能较术前改善(P<0.05),生活质量明显提高。结论腹腔镜下胃旁路手术治疗T2DM效果显著,能提高患者的生活质量。Objective To study the therapeutic effect of laparoscopic Roux-en-Y gastric bypass （LRYGB） on type 2 diabetes mellitus and on the patients＇ life quality.Methods The data of 68 patients with T2DM undergoing LRYGB from May 2010 to May 2012 were retrospectively analyzed.All the patients followed were investigated with SF-36 questionnaire and the data of weight,BMI,FPG,HbA1c,lipid,insulin,C-peptide and the complications of T2DM were recorded and analyzed.Results Among 68 LRYGB patients,46 （67.6％） patients showed T2DM remission,18 （26.5％） showed better glycemic control.And improvements of T2DM complications were found in 14（53.8％）patients with hypertension,15 （71.4％） with hyperlipidemia,3（21.4％） with retinopathy,7 （41.2％） with nephropathy and 3 （27.3％） with neuropathy.The physiological function,general and mental health,social function,emotional status and the quality of life in the T2DM patients receiving LRYGB are all improved significantly.Conclusion This study shows that laparoscopic gastric bypass is a successful treatment for T2DM,which improves the patients＇ quality of life.

关 键 词：糖尿病 2型 腹腔镜胃旁路术 生活质量 

分 类 号：R656.61[医药卫生—外科学]