低体重指数2型糖尿病并胃间质瘤患者腹腔镜下行Roux-en-Y胃旁路术1例  

Laparoscopic Roux-en-Y gastric bypass in Type 2 diabetes mellitus patient with low body mass index and gastric stromal tumor:A case report

作　　者：李伟正[1] 俞照妹 朱利勇[1] 李鹏洲[1] 杨湘武[1] 朱晒红[1] LI Weizheng;YU Zhaomei;ZHU Liyong;LI Pengzhou;YANG Xiangwu;ZHU Shaihong(Department of General Surgery,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院普外科,长沙410013

出　　处：《中南大学学报（医学版）》2021年第1期98-103,共6页Journal of Central South University ：Medical Science

基　　金：supported by the “New Xiangya Talent Projects” of Third Xiangya Hospital of Central South University,China(JY201609)。

摘　　要：在中国,腹腔镜下Roux-en-Y胃旁路手术(laparoscopic Roux-en-Y gastric bypass,LRYGB)已被证明是一种治疗体重指数(body mass index,BMI)>27.5 kg/m2的2型糖尿病(Type 2 diabetes mellitus,T2DM)患者的安全有效的方法。胃肠道间质瘤(gastrointestinal stromal tumor,GIST)的发病率很低,而关于GIST和LRYGB的相关研究稀少。本例男性低BMI的T2DM合并GIST行LRYGB患者为首例报道。病例的体重和身高分别为67 kg和175 cm,BMI为21.9 kg/m2,通过胃镜和增强CT诊断患有GIST。该患者在接受LRYGB的同时接受GIST和T2DM治疗,手术成功摘除GIST。术后4个月和1年的血糖和糖化血红蛋白水平正常;随访胃镜及腹部CT检查,未发现局部复发及转移。LRYGB可能是治疗低BMI T2DM合并GIST的最佳选择。Laparoscopic Roux-en-Y gastric bypass(LRYGB)has been proved to be a safe and effective treatment for Type 2 diabetes mellitus(T2DM)patients with body mass index(BMI)>27.5 kg/m2 in China.The incidence of gastrointestinal stromal tumor(GIST)is very low,whereas the relevant studies on GIST and LRYGB are few.This is the first report of GIST associated with LRYGB in low BMI Chinese patient with T2DM.A male patient with GIST and T2DM,whose body weight and height were 67 kg and 175 cm,respectively,and the calculated BMI was 21.9 kg/m2.He was diagnosed by gastroscopy and enhanced CT scan.We used LRYGB to treat GIST and T2DM at the same time.After the operation,the GIST was removed successfully.Both the blood glucose levels and glycosylated hemoglobin were normal at 4 months and 1 year later.The patient received follow-up gastroscopy and abdominal CT scan and did not find out local recurrence and metastasis.LRYGB may be the best choice in treating GIST in T2DM with low BMI.

关 键 词：腹腔镜下Roux-en-Y胃旁路手术 胃肠道间质肿瘤 2型糖尿病 体重指数 

分 类 号：R587.2[医药卫生—内分泌] R735.2[医药卫生—内科学]