摘要
目的探讨腹腔镜Roux—en—Y胃旁路术治疗合并血脂紊乱的2型糖尿病（type 2 diabetes mellitus，T2DM）患者的效果。方法回顾性分析2012年6月至2014年6月在北京世纪坛医院接受腹腔镜Roux—en—Y胃旁路术治疗的T2DM患者36例，分为两组：组1（22例），合并血脂紊乱；组2（14例），未合并血脂紊乱。结果术后12个月，组1患者BMI由术前（33．5±5．2）kg／m^2降到（26．8±3．9）kg／m^2，空腹血糖和HbA1c较术前明显改善[（8．6±1．8）mmol／L比（5．6±1．2）mmol／L，t=7．707，P=0．000；（7．8％±1．3％）比（6．1％±1．0％），t=8．186，P：0．000]；组2患者BMI由术前（31．6±2．8）kg／m^2降到（27．4±3．3）kg／m^2，空腹血糖较术前明显改善[（8．3±1．5）mmol／L比（6．1±1．6）mmoL／L，t=4．564，P=0．001]，HbA1c较术前无明显改善[（7．4％±1．8％）比（6．5％±0．9％），t=1．827，P=0．091]。2组术后的胰岛素抵抗指数均较术前改善[（8．0±5．8）比（2．2±3．2），t=5．979，P=0．000；（8．1±6．1）比（2．2±1．9），t=3．528，P=0．004]。2组术后12个月糖尿病完全缓解率和血糖、HbA1c的变化值差异均无统计学意义（均P〉0．05）。结论血脂紊乱未对T2DM患者胃旁路手术的疗效产生影响。
Objective To compare the effects of laparoscopic Ronx-en-Y gastric bypass （LRYGB） for the treatment of type 2 diabetes mellitus （T2DM） patients with/withou dyslipidemia. Methods A total of 36 T2DM patients undergoing LRYGB were enrolled in this study in our hospital from June 2012 to June 2014. The mean age was 42. 4 ±11.5, and the mean body mass index （BMI） was （32. 8 ±4. 5 ） kg/m2 before surgery. Patients were divided into dyslipidemia group （ n = 22） and normal group （ n = 14）. Clinical data of the two groups were compared 12 months after surgery. Results All the patients were successfully operated, and followed up for minimum of 12 months. In dyslipidemia patients BMI decreased from （33.5 ±5.2） kg/m^2 to （26. 8 ±3.9）kg/m^2 12 months after surgery, fasting blood glucose decreased from （8.6 ±1.8）mmol/L to （5.6±1.2） mmol/L （t =7.707, P =0. 000）,and HbA1c decreased from （7.8% ±1.3% ） to （ 6. 1% ± 1.0% ） （t =8. 186, P =0. 000） ; In ortholiposis group BMI decreased from （31.6 ±2. 8 ） kg/m^2 to （27.4 ±3.3 ） kg/m^2, as fasting blood glucose decreased from （ 8.3 ±1.5 ） mmol/L to （6. 1 ±1.6）mmol/L（t=4.564,P=0.001）,and HbAlc decreased from （7.4% -＋1.8%） to （6.5% ＋0.9%） （t = 1. 827, P = 0. 091 ）. Homa-IR in both groups significantly improved after surgery （ 8.0 ±5.8 ） vs. （2.2±3.2）, （t=5.979,P=0. 000）; （8.1±6.1） vs. （2.2±1.9）, （t=3.528,P=0.004）. Complete remission ratio as well as glucose and HbAlc changes 1 year after surgery were without differences between the two groups. Conclusion Preoperative blood fat status exerts no significant effect on the prognosis of T2DM patients undergoing laparoscopic Roux-en-Y gastric bypass.
出处
《中华普通外科杂志》
CSCD
北大核心
2017年第2期137-140,共4页
Chinese Journal of General Surgery
