Roux-en-Y胃旁路术与袖状胃切除术治疗肥胖症合并2型糖尿病的效果比较  

Comparison of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy for Obesity Complicated by Type 2 Diabetes Mellitus

作　　者：李旭忠[1] 赵艳生 靳金彪 马廷午[1] 杨西鹏[1] LI Xu-zhong;ZHAO Yan-sheng;JIN Jin-biao;MA Ting-wu;YANG Xi-peng(The Second Department of General Surgery,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]濮阳市油田总医院普外二科,河南濮阳457001

出　　处：《实用临床医学（江西）》2020年第8期30-32,共3页Practical Clinical Medicine

摘　　要：目的比较Roux-en-Y胃旁路术与袖状胃切除术治疗肥胖症合并2型糖尿病的临床效果。方法将68例肥胖症合并糖尿病患者依据性别、体重进行分层随机分组,观察组34例采用袖状胃切除术治疗,对照组34例采用Roux-en-Y胃旁路术治疗。比较2组术前与术后3、6、12个月体重、体质量指数(BMI)、腰围及血糖相关指标[空腹血糖(FPG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)]的变化情况,观察2组术后并发症发生情况。结果2组术前体重、BMI、腰围、FPG、HbAlc、HOMA-IR各项指标比较差异均无统计学意义(P>0.05);2组术后3、6、12个月各项指标均较术前显著降低(P<0.05),但2组术后各时间点各项指标比较差异均无统计学意义(P>0.05)。观察组术后并发症发生率为5.88%,显著低于对照组的23.53%,差异有统计学意义(χ^2=4.221、P=0.039)。结论Roux-en-Y胃旁路术与袖状胃切除术均可有效治疗肥胖症合并2型糖尿病,但袖状胃切除术的术后并发症较少,术前需根据患者病情选择合适术式。Objective To evaluate the clinical effects of Roux-en-Y gastric bypass and sleeve gastrectomy on obesity complicated by type 2 diabetes.Methods Using the stratified random grouping,68 obesity patients with type 2 diabetes were assigned to receive either Roux-en-Y gastric bypass(control group,n=34)or sleeve gastrectomy(observation group,n=34)according to gender and weight.Body weight,body mass index(BMI),waist circumference,fasting blood-glucose(FPG),glycosylated hemoglobin(HbAlc)and insulin resistance index(HOMA-IR)were measured before and 3,6 and 12 months after treatment.Furthermore,postoperative complications were compared between the two groups.Results There were no significant differences in body weight,BMI,waist circumference,FPG,HbAlc and HOMA-IR between the two groups before operation(P>0.05).All the indicators remarkably decreased after 3,6 and 12 months after treatment(P<0.05).However,these indicators were not different at different time points(P>0.05).The incidence of postoperative complications in observation group(5.88%)was lower than that in control group(23.53%)(χ^2=4.221,P=0.039).Conclusion Both Roux-en-Y gastric bypass and sleeve gastrectomy are effective for obesity complicated by type 2 diabetes.However,sleeve gastrectomy results in less postoperative complications than Roux-en-Y gastric bypass.Therefore,the surgical procedure should be selected according to the patient’s condition.

关 键 词：肥胖症 2型糖尿病 ROUX-EN-Y胃旁路术 袖状胃切除术 临床效果 

分 类 号：R656.6[医药卫生—外科学]