腹腔镜可调节性胃束带术治疗肥胖症伴2型糖尿病的近期疗效

Short-term outcome of laparoscopic adjustable gastric banding for morbid obesity complicated with type 2 diabetes

目的观察腹腔镜可调节性胃束带术（laparoscopic adjustable gastric banding，LAGB）治疗病态肥胖症伴2型糖尿病的近期疗效。方法对2006年10月至2007年8月收治的8例病态肥胖症伴2型糖尿病患者行LAGB治疗，监测术后1、3、6、9个月体质量变化，餐前空腹血糖和餐后2h血糖变化，胰岛素及口服降糖药的使用情况。结果8例患者术后体质量均减轻，术后9个月平均体质量指数由术前（38．7±7．5）kg／m^2降至（30．5±4．3）kg／m^2；6、9个月血糖水平明显下降，4例降至正常；9个月3例皮下注射胰岛素者改为口服降糖药物，4例停用降糖药物，1例注射胰岛素但减量。结论LAGB能有效治疗病态肥胖症伴2型糖尿病，近期疗效良好。

Objective To investigate the short-term outcome of laparoscopic adjustable gastric banding （LAGB） for morbid obesity complicated with type 2 diabetes. Methods Eight morbidly obese patients with type 2 diabetes underwent LAGB from October 2006 to August 2007. The weight parameters, fasting （FBG） and 2-hour blood glucose （2hBG）, medication for diabetes were assessed 1,3, 6 and 9 months after surgery. Results All of the patients lost weight, with a mean body mass index decreased from （38.7±7.5） kg/m^2 before LAGB to （30.5 ±4.3 ） kg/m^z 9 months after LAGB. The FBG and 2hBG were decreased significantly at month 6 and 9 after LAGB, with normal FBG and 2hBG in 4 patients. At month 9 after LAGB, 3 of 5 patients with insulin treatment before LAGB were changed to oral hypoglycemics, 1 was continuously administered with a reduced dose of insulin, and 4 patients stopped any medication. Conclusion LAGB is an effective procedure in the treatment of morbid obesity complicated with type 2 diabetes with a favorable short-term outcome.