腹腔镜Roux-en-Y胃旁路术治疗2型糖尿病的疗效分析

Curative effect analysis of laparoscopic Roux-en-Y gastric bypass to treat type 2 diabetes mellitus

目的探讨腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)对2型糖尿病的治疗效果及手术操作要点。方法收集2011年1月至2012年1月在哈尔滨医科大学附属第四医院接受LRYGB的41例2型糖尿病患者的临床资料,对比术前及术后体重、血糖及血脂水平的变化情况,采用两样本t检验进行计量资料的比较。结果所有患者均成功完成手术,无中转开放,无严重术后并发症发生。手术时间(148±21)min,术后(3.0±1.4)d下地活动,术后(3.3±1.2)d恢复流食,术后住院时间为(15.0±4.1)d。所有患者均随访3年,随访期间,糖尿病及代谢异常综合征均明显缓解,各项肥胖指标明显降低,且差异有统计学意义(P<0.05)。结论 LRYGB对合并肥胖的2型糖尿病患者有良好的治疗效果,值得临床广泛开展。

Objective To investigate the effects of laparoscopic Roux-en-Y gastric bypass （LRYGB） in treating type 2 diabetes mellitus （T2DM） and the operation essentials of LRYGB.Methods The clinical data of 41 T2DM patients who underwent LRYGB in the Fourth Affiliated Hospital of Harbin Medical University during January 2011 to January 2012 was analyzed. Changes of weight, blood glucose and blood lipid levels before and after operations were compared. The measurement data was compared by Independent-Samplest Test.Results All procedures were successfully without conversion to open operation. No serious postoperative complications were happened. The operative time was （148±21） min. time to ambulation was （3.0±1.4） d, liquid intake at （3.3±1.2） d, and postoperative hospitalization （15.0±4.1） d. Symptoms of T2DM and metabolic disorders were relieved significantly, and the obesity indexes were also decreased significantly（P〈0.05）.Conclusions LRYGB is effective for obese T2DM which is worthy of clinical application.