3D腹腔镜下袖状胃切除术治疗肥胖合并2型糖尿病的临床疗效及影响因素分析

Clinical efficacy and influencing factors of 3D laparoscopic sleeve gastrectomy for the treatment of obesity combined with type 2 diabetes mellitus

目的探究3D腹腔镜袖状胃切除术(LSG)在治疗2型糖尿病(T2DM)合并肥胖症患者中的临床疗效,分析LSG在治疗T2DM中的影响因素。方法回顾性分析2019年1月至2022年1月接受LSG治疗的65例T2DM肥胖患者的临床资料,分别在术后第1月、3月、6月和12月进行随访。使用SPSS 26.0统计软件进行数据分析,手术前后BMI、血糖、血脂等计量资料以(x±s)表示,采用独立样本t检验。计数资料采用χ^(2)检验分析。采用Logistics回归分析临床疗效的影响因素。P<0.05为差异有统计学意义。结果所有患者均完成了术后随访,随访率100%。BMI、空腹血糖(FPG)、C肽、糖化血红蛋白(HbA1c)、总胆固醇(CHOL)、甘油三酯(TG)和空腹胰岛素水平(FINS)在术后1年都得到了缓解。多变量分析显示,T2DM病程、C肽和FINS是影响LSG后T2DM疗效的因素。结论LSG在减轻体重的同时对T2DM患者有明显的治疗效果,但其长期疗效尚需要进一步验证。

Objective To study 3D laparoscopic sleeve gastrectomy(LSG)in the treatment of type 2 diabetes mellitus(T2DM)combined with obesity and observe its clinical efficacy,and analyze the factors influencing LSG in the treatment of T2DM.Methods Clinical data of 65 obese patients with T2DM treated with LSG from January 2019 to January 2022 were reviewed and analyzed.Follow-up was performed at months 1,3,6,and 12 within 1 year after surgery.Statistical analysis was performed using SPSS 26.0,and the measurement data were expressed as(x±s)deviation with independent samples t test.Count data were analyzed using theχ^(2) test,and logistic regression analysis was used to investigate the multiple factors affecting clinical outcomes.Differences were considered statistically significant at P<0.05.Results All patients completed 1-year postoperative follow-up,and no patients dropped out.BMI,fasting glucose(FPG),fasting C-peptide,hemoglobin A1c(HbA1c),total cholesterol(CHOL),triglycerides(TG),and fasting insulin levels(FINS)were all in remission at 1 year postoperatively.Multivariate analysis showed that the duration of T2DM disease,C-peptide,and FINS were factors influencing the efficacy of T2DM after LSG.Conclusion LSG has a significant therapeutic effect on T2DM patients while reducing body weight,but its long-term efficacy needs further validation.