腹腔镜袖状胃切除术对肥胖患者关节疼痛的缓解效果研究

Effect research of laparoscopic sleeve gastrectomy on relieving joint pain in obese patients

目的分析腹腔镜袖状胃切除术前后肥胖患者下肢关节疼痛的变化并探讨相关原因。方法对2017~2019年间于我院行腹腔镜袖状胃切除术的93例患者进行回顾性分析,比较术前及术后1月患者体重、血糖等代谢指标以及下肢关节疼痛评分的变化。使用相关性分析评价下肢关节疼痛改善可能的原因。结果患者术后1月体重平均下降(11.73±3.99)kg,平均多余体重减少百分比(%EWL)为(35.2±18.4)%,患者术前NRS疼痛评分(3.38±0.10)分,术后1月随访时降至(1.32±0.11)分,两组有显著统计学差异(P<0.001),相关性分析发现疼痛改善程度与术前糖化血红蛋白相关(P<0.01),与%EWL无关。结论腹腔镜袖状胃切除术可以有效改善肥胖及下肢关节疼痛,疼痛的改善程度和术前糖化血红蛋白相关。

Objective Lower limb joint pain is a common complication of obesity.As one of the most effective method of weight loss,limited evidence was reported to explore the effect of laparoscopic sleeve gastrectomy on lower limb joint pain.The objective of this study is to observe the pain severity of lower limb joint before and after laparoscopic sleeve gastrectomy and to explore the cause of amelioration.Methods We performed a retrospective study including 93 patients who received laparoscopic sleeve gastrectomy in our center during 2017~2019.Body weight,metabolic markers and NRS scores were compared before and after the surgery.Correlation analysis were then performed.Results Body weight was reduced by(11.73±3.99)kg and percentage of excess weight loss was(35.2±18.4)%1 month after laparoscopic sleeve gastrectomy.NRS scores were reduced from(3.38±0.10)to(1.32±0.11)(P<0.001).The scale of pain amelioration was correlated to baseline HbA1c(P<0.01).Interestingly,it is not correlated to excess weight loss.Conclusions Laparoscopic sleeve gastrectomy dramatically ameliorated the lower limb joint pain in obese patient.The pain improvement scale was related to baseline HbA1c.