腹腔镜袖状胃切除术治疗肥胖合并2型糖尿病的早期临床疗效分析

Short-term clinical outcome of laparoscopic sleeve gastrectomy in treating obesity combined with type 2 diabetes mellitus

目的探究腹腔镜袖状胃切除术(LSG)治疗肥胖合并2型糖尿病(T2MD)的早期临床疗效。方法回顾性分析2016年6月至2018年12月收治的58例肥胖症且合并T2MD患者临床资料。27例患者纳入LSG组,31例行腹腔镜胃旁路术患者纳入LRYGB组。使用SPSS24.0软件进行统计学分析,两组患者围手术期指标、糖脂代谢指标等计量资料采用(x±s)表示,组间比较采用独立样本t检验;并发症发生率、T2MD治疗效果两组间比较采用χ^2检验。以P<0.05为差异有统计学意义。结果58例患者均成功在腹腔镜下完成手术。LSG组手术用时明显短于LRYGB组(P<0.05);两组在手术出血量、术后排气时间、术后住院天数及术后并发症发生率等,差异无统计学意义(P>0.05)。术后3个月及6个月,两组患者BMI、血糖代谢指标、脂代谢指标均较术前明显下降(P<0.05),而营养指标白蛋白无明显变化(P>0.05);两组间差异无统计学意义(P>0.05)。LSG组对T2MD的临床完全缓解率为77.8%,LRYGB组为74.2%,两组治疗效果相当(P>0.05)。结论LSG术作为独立减重术式安全有效,早期对于肥胖合并T2MD患者疗效佳,值得临床推广。

Objective To investigate short-term clinical outcome of laparoscopic sleeve gastrectomy in treating obesity combined with type 2 diabetes mellitus.Methods From June 2016 to December 2018,clinical data of 58 patients with both obesity and type 2 diabetes were analyzed retrospectively,including 27 patients underwent laparoscopic sleeve gastrectomy were divided into LSG group,while 31 patients underwent laparoscopic gastric bypass were divided into LRYGB group.Statistical analysis were performed by using SPSS24.0 software.Measurement data such as Perioperative indexes、glucose and lipid metabolism indexes were expressed as (x±s) and were examined by using Independent sample t test.Count data such as complication rate、clinical outcome were expressed as%,and were examined by usingχ^2.A P value of<0.05 was considered as statistically significant.difference.Results All of 58 patients underwent successful laparoscopic surgery.The operation time in LSG group was significantly shorter than that in LRYGB group(P<0.05).At 3 months and 6 months postoperatively,BMI,glucose metabolism index and lipid metabolism index of the patients in the two groups decreased significantly than before(P<0.05),while there were no significant changes in terms of serum albumin(P>0.05).But there was no statistically significant difference between the two groups postoperatively(P>0.05).The clinical complete response rate for type 2 diabetes was 77.8%in the LSG group and 74.2%in the LRYGB group,with similar therapeutic effects in two groups for type 2 diabetes(P>0.05).Conclusion LSG is safe and effective as an independent weight loss operation,and is effective for obese patients with type 2 diabetes in the early stage,which is worthy of clinical promotion.