腹腔镜下空回肠侧侧吻合术对2型糖尿病糖脂代谢的影响  

Effect of laparoscopic side-to-side jejunoileal anastomosis on glucose and lipid metabolism in type 2 diabetes mellitus

作　　者：王中会 吕洪亮 孙铁梁 戴春雷 杨聚鹏 刘明 谷洋 张红裔 金虎 WANG Zhonghui;LYU Hongliang;SUN Tieliang;DAI Chunlei;YANG Jupeng;LIU Ming;GU Yang;ZHANG Hongyi;JIN Hu(The Second General Surgery Department,Jilin Province General FAW Hospital,Changchun,Jilin 130011,China)

机构地区：[1]吉林省一汽总医院普外二科,吉林长春130011

出　　处：《中国临床研究》2023年第5期661-664,共4页Chinese Journal of Clinical Research

基　　金：吉林省卫健委青年科技骨干培养计划(2019Q040);吉林省自然科学基金(20200201585JC)。

摘　　要：目的分析腹腔镜下空回肠侧侧吻合术对2型糖尿病患者血糖及血脂代谢的影响。方法对2018年1月至2019年2月吉林省一汽总医院诊断2型糖尿病并接受腹腔镜下空肠回肠侧侧吻合术患者52例的临床资料进行回顾性分析,分析术前及术后3年总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)的变化情况。结果52例患者中,术后3年血糖控制完全缓解23例,部分缓解11例,明显改善8例,无效10例,总体有效率80.77%。2型糖尿病患者预防动脉粥样硬化性心血管疾病(ASCVD)高危人群的控制目标中,术后LDL-C<2.6 mmol/L的达标率(74.19%vs 12.90%),TG<1.7 mmol/L的达标率(77.42%vs 48.39%)较术前显著提高(P<0.05)。对于极高危人群的主要目标中,LDL-C<1.8 mmol/L的达标率术后较术前显著提高(71.43%vs 7.14%,P<0.01)。术后随访3年,TC、TG、LDL-C、HbA1c水平均较术前降低(P<0.01)。结论腹腔镜下空回肠侧侧吻合术治疗2型糖尿病可以有效缓解血糖及血脂代谢异常。Objective To analyze the effect of laparoscopic side-to-side jejunoileal anastomosis on blood glucose and lipid metabolism in type 2 diabetes mellitus(T2DM)patients.Methods The clinical data of 52 patients with T2DM diagnosed in Jilin Province FAW Hospital from January 2018 to February 2019 who underwent laparoscopic side-to-side jejunoileal anastomosis were retrospectively analyzed.The changes of total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and glycosylated hemoglobin(HbA1c)before and 3 years after the operation were analyzed.Results Among the 52 patients,23 had complete remission,11 had partial remission,8 had significant improvement,and 10 had no effect at 3 years after surgery.The overall effective rate of blood glucose control was 80.77%.In the control goal of preventing atherosclerosis cardiovascular disease(ASCVD)high-risk groups in T2DM patients,the rate of reaching the target of LDL-C<2.6 mmol/L(74.19%vs 12.90%)and TG<1.7 mmol/L(77.42%vs 48.39%)after surgery were significantly higher than those before surgery(P<0.05).Among the main targets for extremely high-risk groups,the rate of reaching the standard for LDL-C<1.8 mmol/L after surgery was significantly higher than that before surgery(71.43%vs 7.14%,P<0.01).After 3 years of follow-up,the levels of TC,TG,LDL-C,and HbA1c were lower than those before surgery(P<0.01).Conclusion Laparoscopic side-to-side jejunoileal anastomosis can effectively alleviate the abnormal metabolism of blood glucose and lipids in the treatment of T2DM.

关 键 词：空回肠侧侧吻合术 2型糖尿病 血糖 血脂 总胆固醇 三酰甘油 高密度脂蛋白胆固醇 低密度脂蛋白胆固醇 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌]