不同类型外科减重手术对肥胖合并2型糖尿病患者的影响及安全性分析  

The influence of different types of surgical bariatric surgery on obese patients with type 2 diabetes mellitus and analysis of its safety

作　　者：李红涛 李广丽 赵华锋 高陈旭 Li Hongtao;Li Guangli;Zhao Huafeng;Gao Chenxu(Department of metabolic surgery,the second people's hospital of Xinxiang,Henan,453000,China)

机构地区：[1]新乡市第二人民医院代谢外科,河南新乡453000

出　　处：《齐齐哈尔医学院学报》2023年第11期1031-1035,共5页Journal of Qiqihar Medical University

摘　　要：目的 探讨不同类型外科减重手术对肥胖合并2型糖尿病患者的影响及安全性。方法 选择2020年6月—2021年12月本院收治的肥胖合并2型糖尿病患者48例作为研究对象,依据随机数表法分为对照组(单吻合口胃旁路术进行治疗)和观察组(袖状胃切除术)两组,每组各24例。术后均观察随访6个月,比较两组体重、腰围、BMI、术前及术后6个月空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、血清甘油三酯(TG)、总胆固醇(TC)、低密度蛋白胆固醇(LDL-C)、高密度蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)水平及生活质量各项评分,术后不良反应发生情况。结果 与对照组相比较,观察组手术时间及住院时间更短,术中出血量更少,与术前相比较,术后6个月两组患者体重均更轻,腰围更短,BMI更小,观察组体重、腰围、BMI情况均优于对照组(P<0.05);术后6个月观察组与对照组患者FPG、2 h PG、HbAlc、血清TG、TC、LDL-C、ALT、AST、γ-GT水平均呈现降低趋势,且观察组更低(P<0.05);生活质量各项评分、血清HDL-C水平均呈现升高趋势,且观察组高于对照组(P<0.05);与对照组相比较,观察组患者不良反应发生率更低,差异均具有统计学意义(P<0.05)。结论 与单吻合口胃旁路术相比较,袖状胃切除术改善肥胖合并2型糖尿病患者的糖脂代谢水平及肝功能的作用更为明显,有助于改善患者生活质量,手术操作简单,具有很好的减重作用,且安全性更高。Objective To investigate the effects and safety of different types of surgical bariatric surgery on obese patients with type 2 diabetes mellitus.Methods A total of 48 obese patients complicated with type 2 diabetes those were admitted to the second people's hospital of Xinxiang city from June 2020 to December 2021 were enrolled as study subjects,and they were divided into the control group(24 patients receiving single anastomotic gastric bypass) and the observation group(24 patients receiving sleeve gastrectomy) according to random number table method.All patients were followed up for 6 months.Body weight,waist circumference,BMI,fasting blood glucose(FPG) preoperative and 6 months after operation,and blood glucose after meal 2 h(2h PG),glycosylated hemoglobin(HbAlc),serum triglyceride(TG),total cholesterol(TC),low density protein cholesterol(LDL-C),high density protein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(γ-GT) levels and quality of life scores,the occurrence of postoperative adverse reactions were compared between the two groups.Results Compared with the control group,the observation group had shorter operation time and hospital stay,and less intraoperative blood loss.Compared with the preoperative results,at 6 months after surgery,both groups were lighter in weight,shorter in waist circumference and lower in BMI.The weight,waist circumference and BMI of the observation group were better than those of the control group(P<0.05).6 months after surgery,FPG,2h PG,HbAlc,serum TG,TC,LDL-C,ALT,AST,γ-GT in both groups showed a decreased trend,and those of the observation group were lower than the control group(P<0.05);the quality of life scores and serum HDL-C levels showed an increasing trend,and those of the observation group were higher than the control group(P<0.05);compared with the control group,the incidence of adverse reactions in the observation group was lower,the difference was statistically significant(P<0.05).Conclusions Compared with sing

关 键 词：2型糖尿病 肥胖 单吻合口胃旁路术 袖状胃切除术 糖脂代谢 

分 类 号：R589.2[医药卫生—内分泌]