腹腔镜下Roux-en-Y胃空肠转流术治疗肥胖型2型糖尿病14例

Laparoscopic Roux-en-Y gastric bypass for obese type 2 diabetes mellitus of 14 cases

目的探讨腹腔镜下Roux-en-Y胃空肠转流术(LRYGB)对肥胖型2型糖尿病的临床疗效。方法以14例肥胖型2型糖尿病患者作为研究对象,实施LRYGB,观察患者术前及术后体重指数(BMI)、空腹血糖(FBG)、餐后2小时血糖(2hPBG)、C肽(C-P)及糖化血红蛋白(HbA1C)的变化情况,分析手术预后的相关因素。结果 14例患者手术顺利,均无术中并发症的发生及中转开腹。术后随访3个月。1例出现腹泻,经饮食调整及口服药物改善,术后3月BMI、FBG、2hPBG、HbA1C均较术前明显降低(P<0.05);C-P在术后1个月开始下降,术后3月明显,但术后3个月与术前比较无明显差异(P=0.08)。结论腹腔镜Roux-en-Y胃空肠转流术治疗肥胖型2型糖尿病近期疗效明显,远期疗效有待进一步观察研究。

Objective To investigate the clinic effects of laparoscopic Roux-en-Y gastric bypass （LRYGB） in treating type 2 diabetes mellitus. Methods Fourteen patients suffering from obese type 2 diabetes mellitus underwent LRYGB. The index changes of body mass index （BMI）, fasting blood glucose （FBG）, 2-hour postprandial blood glucose （2 h PBG）, C peptide （C-P） and glycosylated hemoglobin （HbA1C） were observed preoperatively and postoperatively, and the prognostic factors were analyzed. Results All the inpatients successfully underwent LRYGB without intraoperative complications or conversion to open surgery, and were followed up for three months. One inpatient suffering from diarrhea had recovered for food adjustment and drinking drug. BMI, FBG, 2h PGB and HbA1C were decreased （P 〈 0.05） three months later. C-P were decreased one month later, and more three months later, but with no statistic meaning （P = 0.08）. Conclusion LRYGB is an obvious short-term treatment for obese type 2 diabetes mellitus, while its long-term effects need further study.