腹腔镜袖状胃切除术对重度肥胖症合并呼吸衰竭的疗效分析

The effect of laparoscopic sleeve gastrectomy on severe obesity combined with respiratory failure

目的探讨腹腔镜袖状胃切除术(LSG)治疗重度肥胖症合并呼吸衰竭患者的疗效。方法回顾性分析2014年1月至2023年6月山西白求恩医院减重代谢外科治疗的24例重度肥胖合并呼吸衰竭患者的临床资料,所有患者均接受LSG,术前和术后6个月对患者的体重、肺功能、血气分析指标进行评估。结果与术前相比,患者手术后的体重[(143.78±15.93)比(106.81±14.37)kg]、BMI[(49.70±4.28)比(36.94±4.46)kg/m^(2)]、呼吸暂停低通气指数[(39.92±2.96)比(19.29±8.45)次/h]、二氧化碳分压[(60.13±6.24)比(44.71±5.74)mm Hg]均降低,差异均有统计学意义(t=21.18,P<0.05;t=24.17,P<0.05;t=11.72,P<0.05;t=9.36,P<0.05);与术前相比,患者手术后的氧分压[(50.42±5.98)mm Hg比(75.13±13.11)mm Hg]、血氧饱和度[(90.08%±6.23%)比(94.58%±3.43%)]、第一秒用力呼气量与用力肺活量的比值[(69.71±2.68)比(74.88±3.13)]均明显升高,差异均有统计学意义(t=7.88,P<0.05;t=4.05,P<0.05;t=5.86,P<0.05)。结论LSG对重度肥胖症合并呼吸衰竭患者具有较好的疗效。

Objective To investigate the efficacy of laparoscopic sleeve gastrectomy(LSG)in the treatment of severe obesity and respiratory failure.Method A retrospective analysis was conducted on 24 patients with severe obesity and respiratory failure at Department of Bariatric and Metabolic Surgery,Shanxi Bethune Hospital from Jan 2014 to Jun 2023.All patients underwent laparoscopic sleeve gastrectomy.Weight,pulmonary function,and arterial blood gas analysis were evaluated in patients preoperatively and 6 months after surgery.Results Body weight after surgery was(143.78±15.93)kg vs.(106.81±14.37)kg,BMI was(49.70±4.28)kg/m^(2)vs.(36.94±4.46)kg/m^(2),AHI was(39.92±2.96)events/h vs.(19.29±8.45)events/h,and carbon dioxide partial pressure was(60.13±6.24)mmHg vs.(44.71±5.74)mmHg,which were all lower compared to those before surgery,and the differences were statistically significant(t=21.18,P<0.05;t=24.17,P<0.05;t=11.72,P<0.05;t=9.36,P<0.05).0xygen partial pressure was(50.42±5.98)mmHg vs.(75.13±13.11)mmHg,oxygen saturation was(90.08%±6.23%)vs.(94.58%±3.43%),and FEV1/FVC was(69.71±2.68)vs.(74.88±3.13),which were all significantly higher compared to those before surgery,and the differences were statistically significant(t=7.88,P<0.05;t=4.05,P<0.05;t=5.86,P<0.05).Conclusion Laparoscopic sleeve gastrectomy has a good efficacy in the treatment of severe obesity and respiratory failure.