腹腔镜胃袖状切除治疗肥胖合并原发性高血压14例报告

Laparoscopic Sleeve Gastrectomy for Esssential Hypertention in Obese Patients: Report of 14 Cases

目的探讨腹腔镜胃袖状切除术（laparoscopic sleeve gastrectomy,LSG）治疗原发性高血压（essential hypertension,EH）的疗效。方法 2012年7月～2014年10月对14例肥胖合并EH行LSG,腹腔镜下超声刀离断胃周韧带,Endo-GIA沿着胃大弯侧行胃袖状切除术。结果 14例LSG均顺利完成。9例术后1周内血压恢复正常,2例术后2周恢复正常,术后1、6个月血压恢复正常分别为2、1例。3例术前服用降压药物者,术后1例停用,2例高血压复发并继续使用降压药物。术后随访1年,患者体重由术前（107.9±20.2）kg下降至（74.1±16.7）kg（t=10.265,P=0.000）;BMI从38.6±4.9降至26.6±3.9（t=9.091,P=0.000）;多余体重下降百分比（percentage of excess weight loss,%EWL）效果显著9例,良好5例。结论 LSG在减轻体重同时对EH亦有明显治疗效果。

Objective To investigate the efficacy of laparoscopic sleeve gastrectomy（ LSG） for essential hypertension（ EH）.Methods Between July 2012 and October 2014,14 obese patients with EH underwent LSG. We cut the perigastric ligaments with an ultrasonic scalpel under general anesthesia,and then performed sleeve gastrectomy with the Endo-GIA along the greater curvature of the stomach. Results The operations were successfully performed in all the 14 patients. The blood pressure recovered to normal level within 1 week postoperatively in 9 cases,within 2 weeks in 2 cases,within 1 month in 2 cases and within 6 months in 1. In 3 patients who needed antihypertensive medication before the operation,the medication was discontinued in 1 case and was required in the other2 cases due to relapse of hypertension. Postoperative follow-up for 1 year showed the body weight decreased from（ 107. 9 ± 20. 2） kg preoperatively to（ 74. 1 ± 16. 7） kg postoperatively（ t = 10. 265,P = 0. 000）. The BMI decreased from 38. 6 ± 4. 9 to 26. 6 ± 3. 9（ t = 9. 091,P = 0. 000）. The percentage of excess weight loss（ % EWL） had significant results in 9 cases and good results in 5 cases.Conclusion LSG has significant curative effects for weight loss and EH.