腹腔镜下胃转流术治疗2型糖尿病临床疗效评价

Clinical effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus

目的评价全腹腔镜下胃转流手术治疗2型糖尿病的临床疗效。方法对42例实施全腹腔镜下胃转流手术治疗的2型糖尿病患者,进行术前与术后的空腹及餐后2 h血糖、糖化血红蛋白、C肽、胰岛素和体重指数(BMI)等指标的比较分析。结果术后6个月空腹血糖、餐后2 h血糖、糖化血红蛋白较术前均有不同程度下降,与手术前比较相差显著(P<0.05),但是餐后血糖比空腹血糖下降得更快且显著;而空腹胰岛素、空腹C肽水平变化不明显;术前胰岛素、C肽水平高者效果更明显;手术治疗有效率100%,其中临床完全缓解率79.9%、临床部分缓解率20.1%。结论全腹腔镜下胃转流手术治疗2型糖尿病,近期临床疗效满意,是一种微创、安全、有效的外科治疗2型糖尿病的方法。

Objective To evaluate the clinical effects of laparoscopic Roux-en-Y gastric bypass（LRYGB） on type 2 diabetes mellitus.Methods Totally 42 patients with type 2 diabetes mellitus who took fully implementation of the gastric bypass surgery using minimally invasive laparoscopy were enrolled.Indicators of fasting and postprandial（2h） blood glucose,glycated hemoglobin,C peptide,insulin and body mass index（BMI） were analyzed preoperatively and postoperatively.Results The levels of fasting（6 months）and postprandial（2h） blood glucose,glycated hemoglobin after operation were decreased compared with those before operations（P0.05）,but the decline in postprandial blood glucose were more significant than that in fasting glucose.There was no obvious change in levels of fasting insulin and fasting C peptide,the operation was more effective for those with higher insulin and C peptide levels before operation.The total effective rate was 100%,clinical complete response rate was 79.9% and clinical partial response rate was 20.1%.Conclusion With the advantages of minimally invasive,safe and effectiveness,LRYGB is a satisfactory treatment method for type 2 diabetes mellitus recently.