摘要
目的评价腹腔镜Roux-en-Y胃分流术(LRYGB)对病态性肥胖合并2型糖尿病患者的治疗效果,探讨该术式治疗糖尿病的可能机制。方法前瞻性分析2007年1月至7月美国克利夫兰医院30例体质量指数(BMI)≥35.00合并2型糖尿病的病态性肥胖患者的临床资料,采用t检验分析患者接受LRYGB后的疗效。结果与术前比较,术后第6个月的BMI、空腹血糖、糖化血红蛋白明显降低(t=27.399,23.025,15.593,P〈0.05)。第2个月治愈率为70%(21/30),第6个月治愈率为90%(27/30),3例糖尿病症状得到改善。进一步分析术后第2个月和第6个月体质量下降程度,改善患者分别为27.89%±5.51%、45.73%±2.82%,治愈患者分别为35.65%±1.97%、58.00%±1.05%,糖尿病治愈患者比改善患者下降幅度大(t=5.755,7.081,P〈0.05)。结论LRYGB对病态性肥胖合并2型糖尿病患者有着良好治疗效果,体质量下降幅度越大,糖尿病治愈可能性就越大。
Objective To evaluate the efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in the treatment of morbid obesity complicated with type 2 diabetes mellitus, and to discuss the mechanism of LRYGB in the treatment of type 2 diabetes mellitus. Methods The clinical data of 30 type 2 diabetes mellitus patients with body mass index (BMI)≥35.00 who had undergone LRYGB from January 2007 to July 2007 in Cleveland Clinic were prospectively analyzed. The pre-and postoperative clinical parameters were analyzed by t test. Results The BMI, fasting plasma glucose and glycosylated hemoglobin were significantly decreased 6 months after the operation ( t = 27. 399, 23. 025, 15. 593, P 〈 0.05). The cure rate at the end of the second month was 70% (21/30), and it was increased to 90% at the end of sixth month (27/30). The condition of the remaining 3 patients were improved. At the end of the second and sixth month after operation, the BMIs of the patients who were cured by LRYGB were decreased by 27.89%±5.51% and 45.73%±2.82% , and the BMts of the patients whose condition was improved were decreased by 35.65%±1.97% and 58.00%±3.05% ( t = 5. 755, 7.081 , P 〈 0. 05). Conclusions LRYGB is effective in the treatment of morbid obesity complicated with type 2 diabetes mellitus. The curability of morbid obesity increases as the BMI decreases.
出处
《中华消化外科杂志》
CAS
CSCD
2009年第1期24-26,共3页
Chinese Journal of Digestive Surgery