腹腔镜Roux-en-Y胃旁路术治疗肥胖型2型糖尿病的三年随访研究  

Three-year follow-up study of laparoscopic Roux-en-Y gastric bypass for treating obese type 2 diabetes mellitus

作　　者：张涛涛[1] 张向文[1] 梁怀祝[1] 赵国华[1] 

机构地区：[1]大连市中心医院胃肠二科,116033

出　　处：《中华肥胖与代谢病电子杂志》2015年第3期128-131,共4页Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition

摘　　要：目的探讨腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)治疗肥胖型2型糖尿病的疗效。方法回顾性分析2008年6月至2012年2月在大连市中心医院接受LRYGB治疗的63例肥胖型2型糖尿病患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。其中男30例,女33例;年龄(42±12)岁。对所有患者在术后第1、6、12、18、24和36个月的人体测量指标和实验室检查结果进行随访研究。手术前后指标的比较采用配对t检验。结果 63例患者均成功完成手术,手术时间(160±20)min,术中出血量(50±30)ml。术后1个月空腹血糖、餐后2小时血糖及糖化血红蛋白即出现有统计学意义的明显下降,且持续至随访结束(P<0.05);体质指数在术后1个月内也出现有统计学意义的明显下降,持续至随访结束(P<0.05)。截至术后3年,54例患者的T2DM临床治愈,9例临床有效。结论LRYGB治疗中国肥胖型2型糖尿病具有良好的临床疗效。术中精准操作,术后减少热量摄入和适量运动有助于临床疗效的长期维持。Objective To investigate the curative effect of laparoscopic Roux-en-Y gastric bypass(LRYGB) on obese type 2 diabetes mellitus. Methods Clinical data of 63 patients undergoing LRYGB with obese T2 DM between June 2008 and February 2012 were studied retrospectively. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among these 63 patients, 30 were males and 33 were females with the average age of(42±12) years old. Anthropometric parameters and laboratory examination results of all patients were studied at 1, 6, 12, 18, 24 and 36 months postoperatively. Clinical indexes before and after operations were compared using t test. Results All 63 procedures were preformed successfully with an average operation time of(160±20) min, and an average blood loss of(50±30) ml. Fasting plasma glucose, postprandial 2-hour plasma glucose and glycosylated hemoglobin A1 c levels at 1 month after surgery were significantly lower than those preoperatively, and differences were also statistically significant at the end of follow-up as compared with those before surgery(P<0.05). Body mass index decreased dramatically within 1 mouth, and difference was also significant at the end of follow-up compared with that before surgery(P<0.05). During the three-year follow-up, T2 DM was resolved in 54 patients, and clinically improved in 9 patients. Conclusions LRYGB has a good curative effect on obese T2 DM patients in China. Precise operation, lower energy intake and moderate physical exercises can be beneficial for long-term effect.

关 键 词：肥胖症 糖尿病 2型 腹腔镜Roux-en-Y胃旁路术 

分 类 号：R656.61[医药卫生—外科学]