3例HIV感染的肥胖患者袖状胃手术的安全性与有效性观察  

The efficacy and safety of laparoscopic sleeve gastrectomyin patients with severe obesity complicated with HIV infection

作　　者：黄建朋 杨骏波 朱胜彬 宗华[1] Huang Jianpeng;Yang Junbo;Zhu Shengbin;Zong Hua(Department of Gastrointestinal Surgery,the Third People’s Hospital,Shenzhen 518100,China)

机构地区：[1]深圳市第三人民医院胃肠外科,深圳518100

出　　处：《中华肥胖与代谢病电子杂志》2023年第1期68-71,共4页Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition

基　　金：白求恩·爱惜康卓越外科基金项目(HZB-20181119-16)。

摘　　要：报道3例合并HIV感染的重度肥胖患者腹腔镜袖状胃术(LSG),分析其有效性和安全性。3例患者术前BMI分别为43.3 kg/m^(2)、39.1kg/m^(2)、36.3 kg/m^(2),CD4^(+)细胞计数分别为436个/μL、122个/μL、533个/μL,术前病毒载量均<100 IU/mL。3例患者术后均无手术并发症出现,于术后第3天出院。术后6个月,患者阻塞性睡眠呼吸暂停低通气综合征(OSAHS)完全缓解,血糖、血脂均降至正常范围,体重分别减轻35 kg、27 kg、22 kg、多余体重减少百分比(%EWL)分别为60.0%、50.2%、52.4%,病毒载量<100 IU/mL,CD4+细胞计数分别为:491个/μL、206个/μL、572个/μL。结果表明经高效抗逆转录病毒治疗后的HIV感染的重度肥胖患者,LSG术后减重效果确切,不增加手术风险,不影响术后抗病毒药物的疗效。The efficacy and safety of laparoscopic sleeve gastrectomy (SG) in 3 patients with severe obesity complicated with HIV infection were analyzed retrospectively. The preoperative body mass index (BMI) of the three patients was 43.3 kg/m^(2), 39.1 kg/m^(2), 36.3 kg/m^(2) respectively, and the CD4^(+) cell count was 436 cells/μL, 122 cells/μL, and 533 cells/μL respectively. The preoperative viral load was<100 IU/mL. Three patients were discharged on the third day after operation without any postoperative complications. Six months after operation, the patient's obstructive sleep apnea hypopnea syndrome was completely relieved, glycemia and triglyceride were reduced to normal range, weight loss was 35 kg, 27 kg, 22 kg, percentage of excess weight loss (% EWL) was 60.0%, 50.2%, 52.4%, viral load was<100 IU/mL, CD4+ cell count was 491 cells/μL, 206 cells/μL, 572 cells/μL respectively. LSG is effective in weight loss of HIV-infected patients with severe obesity after highly effective antiretroviral therapy, which does not increase the risk of surgery, and does not affect the efficacy of antiviral drugs after surgery.

关 键 词：肥胖 HIV感染 腹腔镜袖状胃切除术 安全性 有效性 

分 类 号：R65[医药卫生—外科学]