47例单纯性肥胖症合并2型糖尿病患者行可调节胃绑带术后随访结果分析

Analysis of Effect of Postoperative Follow-up Results from 47 Cases of Simple Obesity Combined with Type 2 Diabetes Underwent Laparoscopic Adjustable Gastric Bandage

目的：考察并分析单纯性肥胖症合并2型糖尿病患者行腹腔镜可调节胃绑带捆扎术后效果。方法：收集自2003年6月~2011年6月间于我院行腹腔镜下胃绑带捆扎术（laparoscopic adjustable gastric banding,LAGB）的肥胖症合并2型糖尿病的患者47例。结果：受试患者的术前体征指标和血常规指标均超出正常水平,餐后2h的血液学指标除高密度脂蛋白胆固醇,其余指标均升高（P〈0.05）。手术后1周内即开始出现额外体重减轻、体重指数、腰围、臀围的下降,术后2年内体重降低速度较高,术后2年各项指标基本达到稳定,其中额外体重减轻、体重指数、腰围、臀围在2年内降低速度较快,平均额外体重减轻2年达56.4%,平均体重指数由41.6kg/m2降低至28.7kg/m2。空腹血糖和糖化血红蛋白术后1年大部分病例恢复正常,2年基本恢复正常。术后合并症均有不同程度改善。术后出现的并发症经对症治疗均治愈。结论：肥胖症合并2型糖尿病的患者行LAGB后2型糖尿病患者的早期缓解依赖于体重的下降,晚期缓解可能涉及更多因素,LAGB是一种安全、尚有效的手术方式。

Objective：To study and analysis of effect of postoperative follow-up results from 47 cases of simple obesity combined with type 2 diabetes underwent laparoscopic adjustable gastric bandage.Methods：From June 2003 to June 2011,47 cases of simple obesity combined with type 2 diabetes underwent laparoscopic gastric bandage banded gastroplasty（LAGB） in our hospital were enrolled in our study.Results：Physical indicators and bloody indicators of patients were exceeded over the normal ones.Except high-density lipoprotein cholesterol,other bloody indicators increased in 2h after meal（P0.05）.The excess weight loss（EWL）,BMI（body mass index）,waist circumference,hip circumference reduced since 1 week after surgery to reduce.Many indicators have balanced till 2 years after surgery.The EWL,BMI,waist circumference,hip circumference were highly reduced within 2 years,with EWL reduced to 56.4%,the average BMI decreased to 31.0% from 41.6 kg/m2 before surgery to 28.7 kg/m2.Fasting blood glucose after surgery 1 year was returned to normal.The complications were improved after operative.Postoperative Adverse reactions were cured after symptomatic treatment.Conclusion：For patients of obesity combined with type 2 diabetes mellitus,it depends on the weight loss for curing type 2 diabetes in short time and depends on more factors including weight loss in long term,and it is safe to undergo LAGB.