腹腔镜下袖状胃切除术对肥胖性2型糖尿病患者凝血系统、血清白脂素水平和糖脂代谢的影响

The effect of laparoscopic sleeve gastrectomy on coagulation system, serum asprosin level, and glycolipid metabolism in obese patients with type 2 diabetes mellitus

目的 探究肥腹腔镜下袖状胃切除术(LSG)对肥胖性2型糖尿病(T2DM)患者凝血功能、血清白脂素(asprosin)水平及糖脂代谢的影响。方法 回顾性分析2020年1月至2021年3月于我院行LSG的21例肥胖性T2DM患者临床病例资料,比较手术前后患者凝血功能指标、血清白脂素、糖脂代谢指标水平。结果 术后1月及3月患者凝血酶原时间、活化部分凝血活酶时间较术前缩短(P<0.05);D-二聚体水平较术前均升高(P<0.05),糖脂代谢指标水平均较术前降低(P<0.05)。手术前后的纤维蛋白原、血清asprosin、高密度脂蛋白胆固醇水平比较差异均无统计学意义(P>0.05)。结论 临床采用LGS治疗肥胖性T2DM患者可明显改善患者糖脂代谢情况,但LGS作为腹腔镜治疗手段,易使凝血系统出现异常,术后血栓形成风险上升,需高度重视并长期检测血栓形成相关指标,及时预防或干预术后并发症的发生。

Objective To explore the effect of laparoscopic sleeve gastrectomy(LSG) on coagulation system, serum asprosin level, and glycolipid metabolism in obese patients with type 2 diabetes mellitus(T2 DM).Methods Clinical data of 21 obese patients with T2 DM treated with LSG in our hospital from January 2020 to March 2021 were analyzed retrospectively. The levels of coagulation function, serum asprosin and glucose and lipid metabolism were compared before and after surgery among the patients.Results The prothrombin time and activated partial thromboplastin time of patients after operation were reduced when compared to those before operation(P<0.05). The level of D-dimer of the patients after operation was increased compared to before operation(P<0.05). The levels of glucose and lipid metabolism indexes after operation were lower than those before operation(P<0.05). There were no significant differences in the levels of fibrinogen, high density lipoprotein cholesterol and serum asprosin before and after operation(P>0.05).Conclusion LGS treatment of obese patients with T2 DM can significantly improve the glucose and lipid metabolism. However, as a laparoscopic treatment, LGS is easy to make the coagulation system abnormal and increases the hazard of thrombosis. It needs high attention and long-term detection of thrombosis-related indicators so that timely prevent or intervene the occurrence of postoperative complications.