腹腔镜Roux-en-Y胃旁路术治疗肥胖伴2型糖尿病的近期疗效分析

Short-term curative effect of laparoscopic Roux-en-Y gastric bypass in the treatment of obesity with type 2 diabetes

目的探讨腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗肥胖伴2型糖尿病(T2DM)患者的近期疗效。方法回顾性分析行LRYGB的36例肥胖伴T2DM患者的临床资料。分析患者体重、体重指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白A1c(HbA1c)、总胆固醇(TC)、低密度脂蛋白(LDL)、甘油三酯(TG)等相关指标的变化。结果36例患者均顺利完成LRYGB。术后出现2例胃瘫、1例肺部感染、1例胃-肠吻合口瘘,均通过保守治疗后治愈。术后住院时间为(6.78±0.85)d,住院总费用为(56822.24±14251.42)元。重复测量资料方差分析显示,行LRYGB的肥胖伴T2DM患者从术前到术后1个月、3个月、6个月体重、BMI、TC、LDL、TG、FPG、2 hPBG、HbA1c逐渐降低(F分别=279.49、322.15、40.44、51.03、37.17、70.66、80.72、58.90,P均<0.05)。额外体重下降百分比(EWL%)在术后1个月、3个月、6个月明显上升(F=276.77,P<0.05)。结论LRYGB治疗肥胖伴T2DM患者的近期临床疗效显著,是一个成本效益较高的干预措施,但远期疗效仍需进一步研究。

Objective To explore the short-term efficacy of laparoscopic Roux-en-Y gastric bypass(LRYGB)in the treatment of obese patients with type 2 diabetes(T2DM).Methods The clinical data of 36 obese patients with T2DM who underwent LRYGB were retrospectively analyzed.Changes in body weight,body mass index(BMI),fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 hPBG),hemoglobin A1c(HbA1c),total cholesterol(TC),lowdensity lipoprotein(LDL),and triglyceride(TG)were analyzed.Results The 36 cases undergoing LRYGB were successfully completed.There were 2 cases of gastroparesis,1 case of pulmonary infection and 1 case of gastroenterostomy leakage.The hospitalization time was 6.78±0.85 days,and the total costs were RMB 56822.24±14251.42.The results showed that the body weight,BMI,TC,LDL,TG,FPG,2 hPBG,and HbA1c were gradually reduced from preoperative to postoperative 1 month,3 months,6 months(F=279.49,322.15,40.44,51.03,37.17,70.66,80.72,58.90,P<0.05).The percentage of extra weight loss(EWL%)showed a significant upward trend from postoperative 1 month to 3 months,6 months(F=276.77,P<0.05).Conclusion LRYGB has significant short-term clinical efficacy in the treatment of obesity patients with T2DM.It is a cost-effective intervention,but the long-term curative effect needs further research.