青少年肥胖病人减重代谢术后短期疗效分析  

Short-term efficacy of bariatric and metabolic surgery in obese adolescents

作　　者：文君君 胡梦杰 张铖 龚铖[1] 袁玉峰[1] 潘定宇[1] 刘志苏[1] 李震[1] Wen Junjun;Hu Mengjie;Zhang Cheng;Gong Cheng;Yuan Yufeng;Pan Dingyu;Liu Zhisu;Li Zhen(Surgery Center for Bariatric&Metabolic Diseases,Department of Hepatobiliary&Pancreatic Surgery,Zhongnan Hospital of Wuhan University,Mini-Invasive Procedure of Hepatobiliary&Pancreatic Disease of Hubei Province,Hubei Wuhan 430071,China)

机构地区：[1]武汉大学中南医院肥胖症与代谢病外科中心,武汉大学中南医院肝胆胰外科,湖北省肝胆胰疾病微创诊治临床医学研究中心,湖北武汉430071

出　　处：《腹部外科》2023年第5期365-369,共5页Journal of Abdominal Surgery

基　　金：国家自然科学基金(82270612);武汉大学中南医院创新培育基金(CXPY2022087)。

摘　　要：目的探讨腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)对青少年(14~21岁)肥胖人群的短期疗效及影响。方法回顾性分析武汉大学中南医院肥胖症与代谢病外科中心于2018年5月至2023年7月期间接受LSG的77例中有随访资料的32例青少年单纯性肥胖或肥胖合并代谢疾病病人的临床资料,分析减重代谢手术对于体重改变、糖代谢、脂代谢、肝功能的影响,以及并发症的情况。结果所有病人均顺利完成腹腔镜手术,无中转开腹及感染、出血、胃漏等术后并发症。术后随访3个月至1年,以下指标均较术前得到明显改善(均P<0.05):体重[术前(111.7±19.6)kg,术后1年(74.3±17.9)kg],体重指数[术前(38.4±5.7)kg/m^(2),术后1年(26.1±5.3)kg/m^(2)],血糖,血脂,尿酸[术前(502.6±105.2)μmol/L,术后6个月(388.7±8.2)μmol/L],肝功能等。结论LSG对治疗青少年肥胖病人的肥胖及代谢性疾病安全有效,短期获益明显,可有效缓解肥胖并发症,多学科团队是确保减重代谢手术安全和术后高效随访的前提。Objective To explore the short-term efficacy and impacts of laparoscopic sleeve gastrectomy(LSG)on obese adolescents aged 14-21 years old.Methods From May 2018 to July 2023,the relevant clinical data were retrospectively reviewed for 32 adolescents with obesity alone or with metabolic diseases undergoing LSG.The effects of bariatric metabolic surgery on weight change,glucose/lipid metabolism,liver function and complications were examined.Results All laparoscopic procedures were successfully completed without any conversion into laparotomy or such postoperative complications as infection,hemorrhage or gastric leakage.After follow-ups for(3-12)month,body weight[(111.7±19.6)vs.(74.3±17.9)kg],body mass index(BMI)[(38.4±5.7)vs.(26.1±5.3)kg/m^(2)],blood glucose,blood lipids,uric acid[(502.6±105.2)vs.(388.7±8.2)μmol/L]and liver function improved significantly as compared with those pre-operation.Conclusion LSG is both safe and effective in the treatment of obesity and metabolic diseases in children and adolescents with obvious short-term benefits.It may effectively alleviate obese complications(P<0.05).Forming a multidisciplinary team is a prerequisite for ensuring the safety and efficient postoperative follow-up of weight loss and metabolism surgery.

关 键 词：腹腔镜胃袖状切除术 青少年 肥胖症 

分 类 号：R656.6[医药卫生—外科学]