腹腔镜袖状胃切除术的疗效分析

Clinical effects of laparoscopic sleeve gastrectomy for obese patients

目的:探讨腹腔镜袖状胃切除术治疗肥胖症的临床疗效及其相关并发症。方法:回顾分析2014年4月至2017年1月为28例肥胖症患者行腹腔镜袖状胃切除术的临床资料。术后随访患者体重、体重指数、血糖、糖化血红蛋白、血脂、血红蛋白、维生素B_(12)、叶酸等指标,计算多余体质量下降百分比。结果:28例患者均顺利完成手术,无中转开腹。随访3~36个月,术后患者体重、体重指数明显下降。2例患者减重效果欠佳,多余体质量下降百分比分别为47.2%与42.9%。10例患者合并2型糖尿病,其中8例仅靠生活及饮食可控制空腹血糖;术后血脂及其他相关肥胖并发症均得到明显缓解。2例合并胃食管反流病,术后未见缓解。无营养不良。结论:腹腔镜袖状胃切除术是高效、安全的减重手术,可明显缓解肥胖症患者的体重及相关肥胖并发症。

Objective： To investigate the curative effect and related complications of laparoscopic sleeve gastrectomy（ LSG） for obesity patients. Methods： The detailed clinical data of 28 obese patients who underwent LSG in the 1 st Affiliated Hospital of Xinjiang Medical University from Apr. 2014 to Jan. 2017 were retrospectively analyzed. Perioperative body weight,body mass index,blood glucose levels,glycosylated hemoglobin,blood lipid indexes,hemoglobin,vitamin B_（12） and folic acid were measured. Postoperative excess weight loss percentage was also calculated. Results： LSG was successfully implemented in all patients without conversion to laparotomy. The follow-up time was 3-36 months,and both body weight and body mass index significantly decreased after operation. There were two patients with no good effect who resulted in 47. 2% and 42. 9% of excess weight loss percentage. Eight cases of ten obese patients combined with type 2 diabetes mellitus could improve their fasting blood glucose levels only through changing daily lifestyles/habits and diet control after surgery. Blood lipid levels and other obesity-related complications significantly improved after operation,however,symptoms of two patients with preoperative gastroesophageal reflux were not relieved. No malnutrition was found. Conclusions： LSG is a significantly effective and safe therapeutic method for obese patients,can reduce the body weight and improve obesity-related complications.