腹腔镜胃旁路术影响2型糖尿病患者排气排便情况的研究  

Laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus

作　　者：周玉龙[1] 韩晓东[1] 狄建忠[1] 张弘玮[1] 杜贻豹[1] 李昆[1] 张频[1] 

机构地区：[1]上海交通大学附属第六人民医院普外科,200233

出　　处：《中华内分泌外科杂志》2015年第3期193-195,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的：研究腹腔镜Roux-en-Y胃旁路术对2型糖尿病患者排气、排便习惯的影响。方法选取2011年2月至2013年3月间行腹腔镜Roux-en-Y胃旁路术70例，以问卷调查的方式对术后6个月以上的患者的排便习惯、排气频率、气味及对日常生活的影响等方面进行统计。结果手术前67.1％的患者认为自己排便习惯正常，68.6％的患者认为排气正常，视觉模拟评分揭示排气、排便情况很少有困扰并不会影响日常生活。手术后47.1％的患者认为自己排便习惯正常，45.7％的患者有稀便和腹泻，稀便患者数增多40％（28／70），术前为7.1％（5／70），差异有统计学意义（P＜0.001），其中42.9％认为与进食高脂肪食物有关（P＜0.001），而便秘的患者明显减少7.1％（5／70），术前为22.9％（16／70），差异有统计学意义（P＝0.016），视觉模拟评分显示57.1％的患者的日常生活及社会活动未受到影响（P＝0.05）。50％的患者认为排气量明显增加，且55.7％有恶臭，与术前比较具有明显差异（P＜0.001），视觉模拟评分显示60％的患者认为这种改变不影响其日常生活及社会交往活动（ P＝0.212）。结论腹腔镜下Roux-en-Y胃旁路术后部分患者出现稀便和腹泻、排气量明显增加及恶臭等不适，但经过适当治疗后，这些改变不会影响其日常生活及社会交往活动。Objective To observe the impact of laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus（T2DM）.Methods 70 cases of T2DM undergoing laparoscopic Roux-en-Y gastric bypass were studied.Changes in bowel habits, frequency and odor of flatulence, and social life were estimated at least 6 months after surgery using a self-administered questionnaire.Results 67.1%of the patients had normal bowel habit, 68.6%of patients maintained normal flatus before undergoing surgery, and visual ana-logue scale reveals bowel and flatus habit would cause little trouble on daily life.47.1% of patients maintained their normal bowel habit, and 45.7%of patients had loose stools and diarrhea after surgery.The number of pa-tients with loose stools significantly increased（28/70, 40% after surgery vs 5/70, 7.1% before surgery）, with statistical difference（ P〈0.001） .42.9%patients believed that eating high-fat diet was related with loose stools （P〈0.001）.Patients with constipation decreased significantly after surgery（5/70, 7.1% vs the preoperative 16/70, 22.9%）, with statistical difference（P=0.016）.Visual analogue scale showed that 57.1% of patients thought their daily life and social activities were not affected（P=0.05）.50%of patients considered an increase flatus, and 55.7%had malodorous flatus, which had statistical significance compared with those before surgery （ P〈0.001） .A visual analogue scale showed that 60%of patients thought that this change would not affect their daily life and social activities（ P=0.212） .Conclusions After laparoscopic Roux-en-Y gastric bypass surgery, some patients had loose stod, diarrhea, increased flatus and and offensive odor, but after proper treatment these changes do not affect their daily life and social activities.

关 键 词：腹腔镜Roux-en-Y胃旁路术 2型糖尿病 排便习惯 排气 

分 类 号：R656.61[医药卫生—外科学]