不同等级肥胖症行腹腔镜袖状胃切除术的临床疗效  

Clinical efficacy of laparoscopic sleeve gastrectomy in obesity patients of different grades

作　　者：张娜[1] 张盛军 买红娟 陈启众[1] 倪睿 俞永涛 陈申思 钱海权 Zhang Na;Zhang Shengjun;Mai Hongjuan;Chen Qizhong;Ni Rui;Yu Yongtao;Chen Shensi;Qian Haiquan(Department of Clinical Nutrition,General Hospital of Ningxia Medical University,Yinchuan 750001,China;Department of Gastrointestinal Surgery,General Hospital of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院临床营养科,银川750001 [2]宁夏医科大学总医院胃肠外科,银川750001

出　　处：《中华消化外科杂志》2023年第8期987-995,共9页Chinese Journal of Digestive Surgery

基　　金：宁夏自然科学基金(2021AAC03370);宁夏科技惠民计划(2020CMG03004)。

摘　　要：目的探讨不同等级肥胖症行腹腔镜袖状胃切除术(LSG)的临床疗效。方法采用回顾性描述性研究方法。收集2018年1月至2021年12月宁夏医科大学总医院收治的139例不同等级肥胖症患者的临床资料;男37例,女102例;年龄为(32±9)岁。139例患者中,Ⅰ级、Ⅱ级、Ⅲ级肥胖症分别为45、44、50例。观察指标:(1)不同等级肥胖症患者术中及术后情况。(2)不同等级肥胖症患者血液学相关指标。(3)不同等级肥胖症患者减重效果相关指标。正态分布的计量资料以x±s表示,3组间比较采用One-way Anova分析,两两比较采用LSD检验。偏态分布的计量资料以M(范围)表示,3组间比较采用Kruskal-Wallis H检验。计数资料以绝对数表示,组间比较采用χ^(2)检验或Fisher确切概率法。重复测量数据采用重复测量方差分析。结果(1)不同等级肥胖症患者术中及术后情况。45例Ⅰ级肥胖症患者手术时间、术中出血量、术后住院时间、术后30 d内再入院分别为2.0(1.5~2.0)h、50(50~100)mL、5(4~6)d、2例。44例Ⅱ级肥胖症患者和50例Ⅲ级肥胖症患者上述指标分别为2.0(1.5~2.0)h、60(50~187)mL、5(4~6)d、4例和2.0(1.5~2.1)h、60(50~135)mL、5(4~7)d、4例。3者手术时间、术中出血量、术后住院时间比较,差异均无统计学意义(H=4.11,0.77,3.59,P>0.05),术后30 d内再入院比较,差异无统计学意义(P>0.05)。(2)不同等级肥胖症患者血液学相关指标。139例患者均完成术后3、6、12个月随访。Ⅰ级肥胖症患者术前,术后3、6、12个月总胆固醇(TC)分别为(4.5±0.9)mmol/L、(4.6±0.9)mmol/L、(4.3±0.8)mmol/L、(4.6±1.1)mmol/L,Ⅱ级和Ⅲ级肥胖症患者上述指标分别为(4.5±0.8)mmol/L、(4.4±0.8)mmol/L、(4.4±1.0)mmol/L、(4.3±0.9)mmol/L和(4.4±1.0)mmol/L、(4.7±1.1)mmol/L、(4.5±0.8)mmol/L、(4.4±0.5)mmol/L,不满足球形检验(χ^(2)=20.81,P<0.05),采用多变量检验结果显示:3者TC时间效应、组间效应、交互效应比较,差异�Objective To investigate the clinical efficacy of laparoscopic sleeve gastrectomy(LSG)in obesity patients of different grades.Methods The retrospective and descriptive study was conducted.The clinical data of 139 obesity patients of different grades who were admitted to the General Hospital of Ningxia Medical University from January 2018 to December 2021 were collected.There were 37 males and 102 females,aged(32±9)years.Of the 139 patients,there were 45 cases of gradeⅠobesity,44 cases of gradeⅡobesity and 50 cases of gradeⅢobesity,respectively.Obser-vation indicators:(1)intraoperative and postoperative situations in obesity patients of different grades;(2)hematological related indicators in obesity patients of different grades;(3)body quality related indicators in obesity patients of different grades.Measurement data with normal distribution were represented as Mean±SD,and comparison within three groups was conducted using the One-way Anova test and comparison between groups was conducted using the LSD test.Measurement data with skewed distribution were represented as M(range),and comparison within three groups was conducted using the Kruskal-Wallis H test.Count data were described as absolute numbers,and comparison between groups was performed using the chi-square test or Fisher exact probability.Repeated measurement data were analyzed by the repeated ANOVA.Results(1)Intraoperative and postoperative situations in obesity patients of different grades.The operation time,volume of intraoperative blood loss,duration of postoperative hospital stay and cases readmitted within 30 days after surgery were 2.0(range,1.5-2.0)hours,50(range,50-100)mL,5(range,4-6)days and 2 in the 45 cases of gradeⅠobesity.The above indicators were 2.0(range,1.5-2.0)hours,60(range,50-187)mL,5(range,4-6)days and 4 in the 44 cases of gradeⅡobesity and 2.0(range,1.5-2.1)hours,60(range,50-135)mL,5(range,4-7)days and 4 in the 50 cases of gradeⅢobesity.There was no significant difference in the operation time,volume of intraoperative

关 键 词：肥胖症 减重手术 肥胖等级 腹腔镜袖状胃切除术 手术疗效 

分 类 号：R656.61[医药卫生—外科学]