腹腔镜胃旁路术治疗肥胖合并2型糖尿病的临床效果  

Clinical effect of laparoscopic Roux-en-Y gastric bypass surgery for the treatment of obesity with type 2 diabetes mellitus

作　　者：鲍峰[1] 向荣超[1] 鲜于剑波[1] 王东[1] 李国强[1] 邓志刚[1] 向春华[1] 智星[1] 刘文[1] 

机构地区：[1]绵阳市中心医院,四川绵阳621000

出　　处：《腹腔镜外科杂志》2017年第1期12-15,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)治疗肥胖合并2型糖尿病(type 2 diabetes mellitus,T2DM)的临床效果。方法:回顾分析2009年3月至2013年5月为7例肥胖合并T2DM患者行LRYGB的临床资料,随访3年,分析手术前后糖脂代谢指标的变化。结果:7例手术均获成功,无_例中转幵腹,术前体重指数(body mass index,BMI)≥27.5 kg/m^2,与术前相比,术后3年BMI下降[(26.47±1.24)vs.(29.87±2.17),P<0.05],空腹血糖[(5.90±0.76)vs.(8.24±2.19),P<0.05]、糖化血红蛋白HbA1c[(6.28±0.42)vs.(8.06±1.73),P<0.05]、总胆固醇[(4.27±0.22)vs.(5.10±0.49),P<0.05]、三酰甘油[(1.59±0.10)vs.(1.97±0.14),P<0.05]、低密度脂蛋白[(2.67±0.32)vs.(3.22±0.12),P<0.05]、高密度脂蛋白[(1.14±0.06)vs.(1.04±0.05),P<0.05]较术前均有明显改善。术后患者均无严重并发症发生。结论:LRYGB治疗肥胖合并T2DM可显著降低患者的BMI,改善血糖、血脂水平,手术安全、有效,值得临床推广应用。Objective：To investigate the clinical effect of laparoscopic Roux-en-Y gastric bypass（LRYGB） for the treatment of obesity with type 2 diabetes mellitus（T2DM） patients.Methods：The clinical data of 7 patients of obesity with T2DM performed LRYGB surgery between Mar.2009 and May 2013 in the department of general surgery of Mianyang Central Hospital were analyzed retrospectively.The changes of glucose and lipid metabolism indicators of 7 patients were analyzed after 3 years of follow-up.Results：All7 cases of obesity with T2DM were successfully operated,and no case was converted to laparotomy,all the patients＇ preoperative body mass index（BMI） were ≥27.5 kg/m2.Compared with the preoperative data,postoperative patients＇ BMI decreased significantly[（26.47±1.24） vs.（29.87＋2.17） P〈0.05],and the fasting plasma glucose[5.90±0.76） vs.（824±2.19）,P0.05],the hemoglobin HbAlc[（6.28±0.42） vs.（8.06±1.73） P〈0.05],the total cholesterol[（4.27±0.22） vs.（5.10±0.49）,P0.05],the triacylglycerol[（1.59±0.10） vs.（1.97±0.14） P〈0.05].the low density lipoprotein[（2.67±0.32） vs.（3.22±0.12）,P0.05],the high density lipoprotein[（1.14±0.06） vs.（1.04±0.05） P0.05]were significantly improved.There were no severe complications after operation.Conclusions：LRYGB for treatment of obesity with T2DM significantly reduces the patient＇s BMI,improves the patient＇ s blood glucose and blood lipid levels,it is a safe and effective treatment method,worthy of clinical application.

关 键 词：肥胖症 糖尿病 2型 腹腔镜检查 胃旁路术 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学] R656.6[医药卫生—临床医学]