腹腔镜胃袖状切除术对于不同体重指数单纯性肥胖患者的疗效分析  

Effect of laparoscopic sleeve gastrectomy on simple obesity patients with different body mass index

作　　者：嵇光年 朱传荣 王绍闯[1] 周玲玲[1] 吴金声[1] Ji Guangnian;Zhu Chuanrong;Wang Shaochuang;Zhou Lingling;Wu Jinsheng(Department of General Surgery,the Affiliated Huaian No.I People's Hospital of Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院普通外科,淮安223300

出　　处：《国际外科学杂志》2024年第5期319-324,共6页International Journal of Surgery

基　　金：江苏省“双创博士”项目(JSSCBS20222033)。

摘　　要：目的探讨腹腔镜胃袖状切除术对不同肥胖程度患者的减重效果。方法回顾性分析2019年3月-2022年5月于南京医科大学附属淮安第一医院接受腹腔镜胃袖状切除术的152例肥胖患者的病历资料,其中女119例(78.3%),男33例(21.7%),年龄18~58岁,平均(30.9±7.9)岁。Ⅰ度肥胖(体重指数30.0~34.9 kg/m^(2))38例、Ⅱ度肥胖(体重指数35.0~39.9 kg/m^(2))57例、Ⅲ度肥胖(体重指数≥40.0 kg/m^(2))57例。记录并分析术前及术后1、3、6、12个月患者身体测量指标、生化指标、多余体重下降百分比及体重下降百分比。采用SPSS 20.0统计软件对数据进行分析。结果152例患者均成功实施腹腔镜胃袖状切除术。体重、体重指数、腰围、臀围、腰臀比、肝功能、血糖、血脂在术后随访各时间点均有下降,尿酸在术后1个月较术前升高,术后3、6、12个月较术前下降。至术后12个月,体重(75.9±17.0)kg(t=15.14,P<0.001)、体重指数(26.2±3.7)kg/m^(2)(t=14.44,P<0.001)、腰围(89.0±10.7)cm(t=9.20,P<0.001)、臀围(100.6±7.6)cm(t=12.67,P<0.001)、谷丙转氨酶(18.2±16.6)μ/L(t=2.83,P=0.018)、谷草转氨酶(15.2±14.2)μ/L(t=2.84,P=0.018)、空腹血糖(4.6±0.5)mmol/L(t=2.01,P=0.026)、甘油三酯(1.1±0.5)mmol/L(t=3.71,P=0.005)、尿酸(340.2±102.7)μmol/L(t=4.46,P=0.001),均较术前降低且差异有统计学意义。术后6个月,Ⅰ、Ⅱ及Ⅲ度肥胖组多余体重下降百分比分别为(92.7±35.5)%、(86.1±16.0)%、(67.5±14.0)%,三组间差异有统计学意义(F=5.38,P=0.010);体重下降百分比分别为(20.5±7.4)%、(28.5±5.2)%、28.9±6.1%,总体差异也有统计学意义(F=3.50,P=0.043)。术后1年,3组间多余体重下降百分比及体重下降百分比差异无统计学意义。结论腹腔镜胃袖状切除术治疗单纯性肥胖效果良好,体重、腰围、臀围、肝功能、血糖、血脂及尿酸均获得改善。术后前6个月,Ⅰ度肥胖较Ⅱ度肥胖患者多余体重下降百分比高,获得相对较好�ObjectiveTo investigate the effect of laparoscopic sleeve gastrectomy(LSG)on weight loss in patients with different degrees of obesity.MethodsA retrospective analysis was performed on 152 patients with obesity who underwent LSG in Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University from March 2019 to May 2022,including 119 females(78.3%)and 33 males(21.7%),with a mean age of(30.9±7.9)years(ranging from 18 to 58 years).The body mass index(BMI)was 30.0-34.9 kg/m^(2),35.0-39.9 kg/m^(2) and≥40.0 kg/m^(2) inⅠ,ⅡandⅢobjesity groups respectively(n=38,57,57).The body measurements,biochemical indexes,percentage of excess weight loss(%EWL)and percentage of total weight loss(%TWL)were collected and analyzed before and after surgery at 1,3,6,12 months.Statistical analysis was conducted using SPSS 22.0 software.ResultsLSG was successfully implemented in 152 patients.Body weight,BMI,waist circumference,hip circumference,waist-to-hip ratio,liver function,blood glucose and lipid parameters all decreased at each time point of postoperative follow-up,while uric acid increased at 1 month and decreased at 3,6 and 12 months after surgery and then gradually decreased.At 12 months after surgery,the body weight was(75.9±17.0)kg(t=15.14,P<0.001),BMI(26.2±3.7)kg/m^(2)(t=14.44,P<0.001),waist circumference(89.0±10.7)cm(t=9.20,P<0.001),hip circumference 100.6±7.6 cm(t=12.67,P<0.001),alanine aminotransferase(18.2±16.6)μ/L(t=2.83,P=0.018),aspartate aminotransferase(15.2±14.2)μ/L(t=2.84,P=0.018),fasting plasma glucose(4.6±0.5)mmol/L(t=2.01,P=0.026),triglyceride 1.1±0.5 mmol/L(t=3.71,P=0.005)and uric acid 340.2±102.7μmol/L(t=4.46,P=0.001),all were lower than those before surgery with statistical significance.At 6 months after surgery,the%EWL inⅠ,ⅡandⅢobesity groups was(92.7±35.5)%,(86.1±16.0)%and(67.5±14.0)%respectively,with statistical significance among the 3 groups(F=5.38,P=0.010).The%TWL was(20.5±7.4)%,(28.5±5.2)%and(28.9±6.1)%in the three groups respectively,and the overall difference was

关 键 词：减肥手术 人体质量指数 体重减轻 

分 类 号：R656.61[医药卫生—外科学]