腹腔镜可调胃束带手术联合艾塞那肽治疗肥胖型2型糖尿病临床疗效分析

发布时间：2018-05-20 23:18

本文选题：糖尿病 + 型　；参考：《中国全科医学》2017年35期

【摘要】：目的比较腹腔镜可调胃束带手术(LAGB)联合术后运用艾塞那肽与Roux-en-Y胃旁路手术(LRYGB)治疗肥胖型2型糖尿病的临床疗效。方法收集2013年1月—2015年1月宜昌市中心人民医院接受LAGB并术后联合使用艾塞那肽(LAGB+E组)和仅行LRYGB(LRYGB组)治疗的肥胖型2型糖尿病患者,每组各20例。监测术前、术后1周、术后1、3、6、12个月患者的体质量、体质指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA_(1c))和空腹C肽水平,评价糖尿病疗效及术后并发症发生情况。结果治疗方法与时间在体质量、BMI、FPG、2 h PG、HbA_(1c)和空腹C肽水平上存在交互作用(P0.05);治疗方法在体质量、BMI、FPG、2h PG、HbA_(1c)和空腹C肽水平上主效应不显著(P0.05);时间在体质量、BMI、FPG、2 h PG、HbA_(1c)和空腹C肽水平上主效应显著(P0.05)。LAGB+E组与LRYGB组患者体质量、BMI、FPG、2 h PG、HbA_(1c)和空腹C肽水平1年变化值比较,差异均无统计学意义(P0.05)。LAGB+E组患者术后糖尿病疗效完全缓解8例、部分缓解11例、无效1例,LRYGB组分别为7例、13例、0例,两组比较差异无统计学意义(u=0.111,P=0.912)。LAGB+E组与LRYGB组患者术后并发症发生率比较,差异无统计学意义[5%(1/20)与25%(5/20),χ~2=1.765,P=0.184]。结论艾塞那肽可增强LAGB治疗肥胖型2型糖尿病的治疗效果,LAGB联合艾塞那肽可取得与LRYGB相当的临床疗效,且术后并发症发生率更低,但其远期疗效还有待于进一步研究。
[Abstract]:Objective to compare the clinical effects of laparoscopic adjustable gastric band operation (LAGB) combined with Roux-en-Y gastric bypass surgery (LRY GB) on obese type 2 diabetes mellitus (T2DM). Methods from January 2013 to January 2015, 20 patients with obese type 2 diabetes mellitus were treated with LAGB in Yichang Central people's Hospital and treated with Isenapeptide LAGB E group and LRYGB(LRYGB group (20 cases in each group). The body mass, body mass index (BMI), fasting blood glucose (FPGN), 2 h postprandial blood glucose (2 h), HbACTH (HbA1cU) and fasting C-peptide levels were monitored before, 1 week and 1 day after operation, 12 months after operation, to evaluate the curative effect of diabetes and the occurrence of postoperative complications. Results there was an interaction between the treatment methods and the time of treatment on the levels of P0.05 and fasting C-peptide in the 2h PGHbAG of BMIFPGG; the main effect of the treatment was not significant P0.05on the body mass of BMIFPGG 2 h PGN HbA1c) and the fasting C-peptide level; the time in body mass of BMIFPGG 2 h PGHbAG was 1c) and the fasting C-peptide level was not significant (P0.05) and the effect was not significant at the level of fasting C-peptide. The main effect was significantly higher than that in the LRYGB group and the P0.05 group. The body mass of the patients was compared with that of the control group. The changes of plasma BMI-FPGG (2 h) and fasting C-peptide levels were compared at the level of P0.05U 路LAGBE and LRYGB, respectively. There was no significant difference in the curative effect of diabetes mellitus in 8 cases, partial remission in 11 cases, failure in 1 case in LRYGB group and 7 cases in LRYGB group, and there were 0 cases in LRYGB group, respectively, in which there were 8 cases of complete remission, 11 cases of partial remission and 1 case of failure of LRYGB group. There was no significant difference between the two groups in the incidence of postoperative complications between the two groups. There was no significant difference in the incidence of postoperative complications between the LAGBE group and the LRYGB group. There was no significant difference in the incidence of postoperative complications between the two groups. There was no significant difference in the incidence of postoperative complications between the two groups (5 / 20) and 25 / 20 (蠂 ~ 2 / 1 765 P ~ (0.184). Conclusion Isenapeptide can enhance the therapeutic effect of LAGB in the treatment of obese type 2 diabetes mellitus. LAGB combined with Isenapeptide can achieve the same clinical effect as LRYGB, and the incidence of postoperative complications is lower, but the long-term effect needs further study.
【作者单位】：三峡大学第一临床医学院宜昌市中心人民医院内分泌科;福建省厦门市第五医院;
【分类号】：R587.1

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