腹腔镜Roux-en-Y胃旁路术治疗肥胖合并2型糖尿病的疗效

Efficacy of Laparoscopic Roux-en-Y Gastric Bypass Surgery in the Treatment of Obesity Accompanied by Type 2 Diabetes

目的:探讨腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗肥胖合并2型糖尿病的疗效。方法:选择54例行LRYGB治疗的2型糖尿病患者,分为研究组[体质量指数(BMI)≥28 kg/m^2]40例和对照组14例(BMI<28 kg/m^2),比较治疗效果。结果:研究组手术总时间长于对照组,两组手术总出血量、术后初次下床活动时间、术后并发症发生率差异均无统计学意义。术后6个月研究组和对照组空腹血糖(FBG)、空腹胰岛素(FINS)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、餐后2 h血糖(2 h FBG)和糖化血红蛋白(HbA1c)均较术前明显降低,空腹C肽显著增高。术后6个月研究组HbA1c水平显著低于对照组(P<0.05)。研究组临床有效率显著高于对照组(P=0.024)。结论:LRYGB治疗肥胖合并2型糖尿病患者较非肥胖患者疗效更好。

Objective ： To investigate the efficacy of laparoscopic Roux-en-Y gastric bypass surgery （LRYGB ） for the treatment of obesity accompanied by type 2 diabetes .Methods ： Fifty-four patients with type 2 diabetes undertaking LRYGB treatment were collected and divided into study group （body mass index ,BMI ≥ 28 kg/m^2 ） with 40 cases and control group （BMI 〈 28 kg/m^2 ） with 14 cases .And therapeutic effect was compared between the two groups .Results ： The total operative time in study group was longer than that in control group .There was no statistically significant difference regarding total amount of intraoperative bleeding , postoperative ambulation first time , postoperative complication rate between the two groups .Six months after surgery ,FBG ,FINS ,HOMA-IR ,2 h FBG and HbA1c in both study group and control group were significantly lower than before surgery ,while fasting C-peptide was significantly higher .And six months after surgery ,HbA1c level in study group was significantly lower than that in control group （P〈 0 .05） .The overall response rate in study group was significantly higher than that in control group （P= 0 .024） .Conclusions ： The efficacy of LRYGB for the treatment of obesity accompanied by type 2 diabetes mellitus patients is better than that of non-obese patients .