腹腔镜胃袖状切除术联合空肠-空肠旁路术对肥胖症病人代谢相关指标的影响  

Effects of laparoscopic sleeve gastrectomy combined with jejunal-jejunal bypass on metabolic indexes in obese patients

作　　者：付丽平 赵象文[1] 况小艳 林凤茹 黄盼儿 Fu Liping;Zhao Xiangwen;Kuang Xiaoyan;Lin Fengru;Huang Pan'er(Department of General Surgery,Xiaolan People's Hospital of Zhongshan(Zhongshan Fifth People's Hospital),Guangdong Zhongshan 528415,China)

机构地区：[1]中山市小榄人民医院,中山市第五人民医院普外科,广东中山528415

出　　处：《腹部外科》2025年第2期147-151,共5页Journal of Abdominal Surgery

基　　金：中国管理科学研究院教育科学研究所重点课题(JKSA22016)。

摘　　要：目的探究腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)联合空肠-空肠旁路术(jejunal-jejunal bypass,JJB)对肥胖症病人代谢指标的影响。方法回顾性分析中山市小榄人民医院2020年7月至2023年7月收治的36例肥胖病人病历信息,根据术式的不同将上述病人分为观察组(n=18,采用LSG+JJB治疗)和对照组(n=18,采用LSG治疗)。比较两组病人术前、术后12个月减重相关指标、脂质代谢、糖代谢、生活质量、并发症情况,生活质量采用生活质量综合评定问卷进行评估。结果术后1年,两组病人体重指数、腰围、腹围、臀围比术前有所降低,且观察组指标低于对照组(均P<0.05)。两组病人术后脂质代谢指标、糖代谢指标、生活质量均较术前有改善,且观察组治疗效果优于对照组(均P<0.05)。两组病人术后未发生严重并发症,并发症发生率组间比较,差异无统计学意义(P>0.05)。结论和单纯LSG比较,采用LSG+JJB治疗对于肥胖症病人而言,更能增强减重效果,改善糖脂代谢功能,提高生活质量,且不会增加术后并发症,安全性较高,可作为减重手术的良好选择。Objective To explore the impacts of laparoscopic sleeve gastrectomy(LSG)combined with jejunal-jejunal bypass(JJB)on metabolic indicators in obese patients.Methods The medical records of 36 obese patients in Xiaolan People's Hospital of Zhongshan from July 2020 to July 2023 were retrospectively analyzed.According to the different surgical methods,patients were divided into the observation group(n=18,LSG+JJB)and control group(n=18,LSG).The weight lossrelated indicators,lipid metabolism,glucose metabolism,quality of life and complications were compared between groups before surgery and 12 months after surgery.Results At 1 year postoperatively,the body mass index(BMI),waist circumference,abdominal circumference,and hip circumference in both groups were significantly reduced compared to preoperative levels,which were significantly lower in the observation group than the control group(all P<0.05).Postoperative lipid metabolism indicators,glucose metabolism indicators,and quality of life in both groups were significantly improved compared to preoperative levels,which were more pronounced in the observation group than the control group(all P<0.05).Severe postoperative complications were not reported in both groups,and there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion For patients with obesity,LSG+JJB treatment can enhance the effect of weight loss,improve the function of glucolipid metabolism,and increase the quality of life,without increasing the risk of postoperative complications.It has a high safety profile and can be used as a good choice for weight loss surgery.

关 键 词：腹腔镜胃袖状切除术 空肠-空肠旁路术 肥胖症 糖脂代谢 

分 类 号：R589.2[医药卫生—内分泌]