腹腔镜下袖状胃切除术治疗代谢综合征的临床疗效  

Clinical efficacy of LSG in the treatment of metabolic syndrome

作　　者：尹小彬 何瑶 谢兴江 陈剑锋[1] 高鑫 李慧 王波[1] YIN Xiaobin;HE Yao;XIE Xingjiang;CHEN Jianfeng;GAO Xin;LI Hui;WANG Bo(Gastrointestinal Surgery Department,Wenjiang District People's Hospital of Chengdu,Chengdu 611100,Sichuan,China;Department of Gastroenterology,Chengdu First People's Hospital,Chengdu 610095,Sichuan,China)

机构地区：[1]成都市温江区人民医院胃肠外科,四川成都611100 [2]成都市第一人民医院消化内科,四川成都610095

出　　处：《中国现代手术学杂志》2024年第2期91-96,共6页Chinese Journal of Modern Operative Surgery

基　　金：四川省医学科研课题计划(S19010)。

摘　　要：目的分析腹腔镜下袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)治疗代谢综合征(metabolic syndrome,MS)的临床疗效。方法选择2019年3月至2022年3月在本院接受LSG治疗并完成1年随访的MS患者92例,收集患者年龄、性别等一般资料,记录患者术前、术后3、6、12个月减重指标[体重、体质指数(body mass index,BMI)、腰围、多余体重减除率(excess weight loss,EWL%)]、脂代谢指标[三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)]、糖代谢指标[糖化血红蛋白(glyeosylated hemoglobin Alc,HbAlc)、空腹血糖(fasting plasma glucose,FPG)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)]、肾功能[肌酐清除率(creatinine clearance,Ccr)、肾小球滤过率(glomerular filtration rate,GFR)、尿酸(uric acid,UA)]。对比患者术前与术后3、6、12个月减重指标、血脂、血糖、肾功能指标改善情况。结果所有患者均顺利完成手术治疗,术中无转开腹者,手术平均时间为(159.67±12.33)min,术中平均出血量(50.16±13.54)mL,均未出现严重并发症,术后恢复情况良好。术后3、6、12个月患者体重、BMI、腰围、EWL%、TG、LDL-C、HbAlc、FPG、HOMA-IR及UA逐渐下降(P<0.05),HDL-C逐渐升高(P<0.05),而Ccr、GFR无明显变化(P>0.05)。结论LSG可有效减轻MS患者体重,改善糖代谢和脂代谢功能,缓解肾功能损伤。Objective To analyze the clinical efficacy of laparoscopic sleeve gastrectomy(LSG)in the treatment of metabolic syndrome(MS).Methods There were 92 MS patients received LSG in our hospital from March 2019 to March 2022 and completed 1-year follow-up.Clinical data was collected preoperatively,and 3-month,6-month-12-month postoperatively,such as weight loss indicators[weight,body mass index(BMI),waist circumference,excess weight loss rate(EWL%)],lipid metabolism indicators[triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],glucose metabolism indicators[glyeosylated hemoglobin Alc(HbAlc),fasting plasma glucose(FPG),homeostasis model assessment of insulin resistance(HOMA-IR)],renal function[creatinine clearance rate(Ccr),glomerular filtration rate(GFR),uric acid(UA)].The indicators were compared among different time points.Results All patients successfully completed surgical treatment,with no conversion to open surgery.The average surgical time was(159.67±12.33)minutes,and the average intraoperative blood loss was(50.16±13.54)mL.No serious complications occurred,and the postoperative recovery was good.The weight,BMI,waist circumference,EWL%,TG,LDL-C,HbAlc,FPG,HOMA-IR and UA gradually decreased(P<0.05),while HDL-C gradually increased(P<0.05).But Ccr and GFR showed no significant changes(P>0.05).Conclusion LSG can effectively reduce the weight of MS patients,improve glucose and lipid metabolism functions,and alleviate renal function damage.

关 键 词：袖状胃切除术 代谢综合征 临床疗效 糖代谢 脂代谢 肾功能 

分 类 号：R656.61[医药卫生—外科学]