腹腔镜袖状胃切除术和腹腔镜Roux-en-Y胃旁路术治疗肥胖合并非酒精性脂肪性肝病的效果比较

Comparison of Effects of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in the Treatment of Obesity Complicated with Nonalcoholic Fatty Liver Disease

目的:比较腹腔镜袖状胃切除术和腹腔镜Roux-en-Y胃旁路术治疗肥胖合并非酒精性脂肪性肝病的效果。方法:选取2015年12月-2018年12月笔者所在医院收治的肥胖合并非酒精性脂肪性肝病患者208例,根据患者临床治疗方式将其分成研究组(134例)和对照组(74例)。分别给予腹腔镜袖状胃切除术和腹腔镜Roux-en-Y胃旁路术治疗。对两组患者的手术指标、体重、BMI值、糖代谢指标和肝功能指标进行观察和比较。结果:研究组患者的术中出血量、手术时间和住院时间明显优于对照组(P<0.05);治疗后1年,两组患者的体重、BMI值、糖代谢指标和肝功能指标均较治疗前明显降低(P<0.05);治疗后,两组患者体重、BMI值、糖代谢指标和肝功能指标比较,差异无统计学意义(P>0.05)。结论:腹腔镜袖状胃切除术和腹腔镜Roux-en-Y胃旁路术治疗肥胖合并非酒精性脂肪性肝病均能取得较好的效果,但腹腔镜袖状胃切除术后患者恢复更快,临床实际中应结合患者个体情况进行手术选择。

Objective:To compare the efficacy of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in the treatment of obesity complicated with nonalcoholic fatty liver disease.Method:According to their clinical treatment,a total of 208 obese patients with nonalcoholic fatty liver disease admitted to our hospital from December 2015 to December 2018 were divided into the study group (134 cases) and the control group (74 cases).They were given laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass,respectivey.The indexes of operation,body weight,BMI,glucose metabolism and liver function were observed and compared.Result:The bleeding volume,operation time and hospitalization time in the study group were significantly better than those in the control group (P<0.05).After treatment for 1 year,the body weight,BMI,glucose metabolism index and liver function index in the study group were significantly lower than those before treatment (P<0.05).After treatment,the body weight,BMI,glucose metabolism index and liver function index in the two groups were not significantly different (P>0.05).Conclusion:Laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass can achieve better results in the treatment of obesity and nonalcoholic fatty liver disease,but the recovery of patients after laparoscopic sleeve gastrectomy is faster.In clinical practice,hand selection should be combined with the individual situation of patients.