MDT管理LSG对肥胖2型糖尿病患者HOMA及糖脂代谢的影响研究  

Study on the effect of MDT management of LSG on HOMA and glucolipid metabolism in obese patients with type 2 diabetes mellitus

作　　者：夏连丽 陈晓蕾[1] 尹剑辉[2] 贾农[1] 张力君[2] 杨悦林[3] 张继宏[2] 刘丽颖 XIA Lian-li;CHEN Xiao-lei;YIN Jian-hui;JIA Nong;ZHANG Li-jun;YANG Yue-lin;ZHANG Ji-hong;LIU Li-ying(Department of Endocrinology;Department of General Surgery;Department of Clinical Laboratory,Kunming First People's Hospital,KunmingYunnan 650000,China)

机构地区：[1]昆明市第一人民医院内分泌科,云南昆明650000 [2]昆明市第一人民医院普外科,云南昆明650000 [3]昆明市第一人民医院检验科,云南昆明650000

出　　处：《云南医药》2021年第5期417-420,436,共5页Medicine and Pharmacy of Yunnan

基　　金：昆明市科技局项目(2019-1-S-25318000001306);昆明市卫建委人才培养“百工程”项目[2020-sw(省)-09]。

摘　　要：目的探讨多学科协作模式(MDT)用于肥胖2型糖尿病腹腔镜袖状胃切除(LSG)术后患者中对稳态模型(HOMA)及糖脂代谢的影响。方法在本院2019年7月-2021年5月收治的肥胖2型糖尿病患者中选取80例,按照随机分组原则分为2组,研究组采用MDT管理LSG,对照组采用常规管理LSG,对比2组代谢指标及HOMA、体重指标及并发症。结果干预前,2组空腹血糖(FBG)、餐后2h血糖(2hPBG)、甘油三酯(TG)、总胆固醇(TC)对比无差异(P>0.05),干预后研究组血糖、血脂指标均低于对照组(P<0.05);干预前2组HOMA-IR、HOMA-β指数对比无差异(P>0.05),干预后研究组HOMA-IR低于对照组(P<0.05),HOMA-β高于对照组(P<0.05);干预前2组体重、BMI对比无差异(P>0.05),干预后研究组体重、BMI均低于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05)。结论在肥胖2型糖尿病患者采用MDT管理LSG有利于糖脂代谢指标的控制,改善胰岛素抵抗水平,促进患者术后康复,降低并发症发生率。Objective To explore the effect of multidisciplinary collaboration model(MDT)on steady state model(HOMA)and glycolipid metabolism in obese patients with type 2 diabetes mellitus after laparoscopic sleeve gastrectomy(LSG).Methods 80 patients with obesity type 2 diabetes who were admitted to our hospital from July 2019 to May 2021 and were divided into two groups according to the principle of random grouping.The study group used multidisciplinary collaboration mode(MDT)to manage laparoscopic sleeve gastrectomy(LSG).The control group received routine management LSG,and compared the two groups of metabolic parameters and HOMA,body weight index and complications.Results Before the intervention,there was no difference in fasting blood glucose(FBG),2h postprandial blood glucose(2hpbg),triglyceride(TG)and total cholesterol(TC)between the two groups(P>0.05);After intervention,blood glucose and serum lipid parameter of study group were lower than those of control group(P<0.05);There was no difference in the comparison of HOMA-IR and HOMA-βin two groups before intervention;HOMA-IR of study group was lower than that of control group(P<0.05),while HOMA-βwas higher than that of control group(P<0.05);There was no significant difference in body weight and BMI between the two groups before the intervention(P<0.05).After the intervention,the body weight and BMI of the study group were lower than those of the control group(P<0.05);The incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusions The use of MDT to manage LSG in obese patients with type 2 diabetes is conducive to the control of glycolipid metabolism indicators,improve insulin resistance level,promote postoperative rehabilitation and reduce the incidence of complications.

关 键 词：多学科协作模式 肥胖 2型糖尿病 腹腔镜袖状胃切除术 

分 类 号：R723.14[医药卫生—儿科]