腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的临床效果

Clinical effect of laparoscopic sleeve gastrectomy in the treatment of obesity with type 2 diabetes mellitus

目的:探讨肥胖症合并2型糖尿病行腹腔镜袖状胃切除术(LSG)的近期疗效。方法:选取2018年6月至2020年6月采用LSG治疗的60例2型糖尿病合并肥胖症患者,根据治疗方法分为LSG组(n=29)与腹腔镜Roux-en-Y胃转流术(LRYGB)组(n=31);分析两组术后3个月、6个月糖代谢及围术期指标的变化,并比较术后并发症发生率及临床疗效。结果:60例患者均成功完成手术。两组术中出血量、术后排气时间、术后并发症、术后住院时间差异无统计学意义(P>0.05),但LSG组手术时间短于LRYGB组(P<0.05);术后3个月、6个月,两组脂代谢指标、糖代谢指标均较术前降低(P<0.05),营养指标白蛋白与术前相比差异无统计学意义(P>0.05)。LRYGB组与LSG组2型糖尿病临床缓解率差异无统计学意义(77.41%vs.75.86%,P>0.05)。结论:LSG是治疗肥胖症合并2型糖尿病安全、有效的独立减重术式,且近期效果明显,值得临床推广应用。

Objective:To investigate the recent efficacy of laparoscopic sleeve gastrectomy(LSG)for obesity with type 2 diabetes mellitus(T2DM).Methods:From Jun.2018 to Jun.2020,60 patients with obesity and T2DM who underwent LSG were enrolled and divided into LSG group(n=29)and laparoscopic Roux-en-Y gastric bypass(LRYGB)group(n=31).The changes of glucose metabolism and perioperative indicators at 3 and 6 months were analyzed,the incidence of postoperative complications and clinical treatment effect were compared.Results:All 60 surgeries were successfully completed.Intraoperative blood loss,postoperative exhaust time,postoperative complications and hospital stay were not significantly different between the two groups(P>0.05),but operative time of LSG group was significantly shorter than that of LRYGB group(P<0.05);In 3 months and 6 months after operation,lipid metabolism indicators,glucose metabolism indicators and body mass index in the two groups were significantly lower than those in preoperative period(P<0.05).There was no significant difference in albumin(P>0.05).The clinical remission rate of T2DM in LRYGB group was 77.41%and 75.86%in LSG group with no significant difference(P>0.05).Conclusions:LSG is a safe and effective independent weight loss operation in the treatment of obesity complicated with T2DM,and has obvious short-term effects,it is worthy of clinical popularization and application.