摘要
目的探讨腹腔镜下胃肠外科手术治疗单纯性肥胖症及其合并2型糖尿病（T2DM）患者的效果及安全性。方法上海第二军医大学附属长海医院微创外科2003年6月至2010年6月间对219例肥胖症患者进行了腹腔镜下胃肠外科手术，其中201例行腹腔镜下可调节胃绑带术（LAGB组），13例行腹腔镜下改良简易型胃肠短路术（LMGB组），5例行腹腔镜下管状胃胃切除术（LSG组）。总结分析该组患者的临床和随访资料。结果LAGB组患者体质量指数（BMI）平均37．9kg／m2，术后6个月及12个月BMI分别为平均32．4kg／mz和29．7kg／m2；43例术前合并T2DM者．11例（25．6％）术后临床部分缓解，16例（37．2％）完全缓解；有26例（12．9％）术后出现并发症。LMGB组患者BMI平均34．7kg／m2，术后6个月及12个月BMl分别为平均31．6kg／m2和26．9kg／m2：10例术前合并T2DM者，2例（20．0％）术后临床部分缓解，7例（70．0％）完全缓解；有2例（15．4％）术后出现并发症。LSG组患者BMI平均43．8kg／m2．术后6个月及12个月BMl分别为平均38．1kg／m2和34．3kg／m2；3例术前合并T2DM者，术后1例达到临床部分缓解，1例完全缓解：有1例术后出现并发症。所有术式组均无围手术期死亡。结论腹腔镜下胃肠外科手术对单纯性肥胖症有效．并能使合并的T2DM得到缓解．同时手术并发症较少。
Objective To evaluate the outcomes after laparoscopic gastrointestinal surgery for patients with obesity and type 2 diabetes mellitus （T2DM）. Methods From June 2003 to June 2010, 219 patients underwent laparoscopie gastrointestinal surgery for obesity and T2DM, including laparoseopie adjustable gastric banding （LAGB,n=201）, laparoscopic mini gastric bypass （LMGB,n=13）, and laparoscopic sleeve gastrectomy （LSG, n=5）. Clinical data were analyzed retrospectively. Results The mean body mass index （BMI） of patients who received LAGB was 37.9 kg/m2, and decreased to 32.4 kg/m2 at 6 months and to 29.7 kg/m2 at 12 months. In 43 patients who had concurrent T2DM, 11 （25.6%） showed clinical partial remission （CPR） and 16 （ 37.2% ） clinical complete remission （CCR）. Postoperative complications occurred in 26 patients （12.9%）. The mean BMI of patients undergoing LMGB was 34.7 kg/m2, and decreased to 31.6 kg/m2 at 6 months and 26.9 kg/m2 at 12 months after surgery. Ten patients had T2DM before operation, of whom 2（20.0%）had CPR and 7（70.0%） CCR postoperatively. Postoperative complications occurred in 2 patients （15.4%）. The mean BMI of patients who underwent LSG was 43.8 kg/m2, and was reduced to 38.1 kg/m2 at 6 months and 34.3 kg/m2 at 12 months after operation. Three patients were diagnosed with T2DM before operation. One patient （33.3%） had CPR and 1（33.3%） reached CCR after operation. There was 1（20.0%） patient who developed complication. No perioperative death occurred. Conclusion Laparoseopic gastrointestinal surgery may result in satisfactory weight loss and clinical remission of T2DM with few complications.
出处
《中华胃肠外科杂志》
CAS
北大核心
2011年第2期128-131,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
肥胖症
单纯
2型糖尿病
外科手术
腹腔镜
Obesity, simple
Type 2 diabetes mellitus
Surgical procedures
Laparoscopy
