腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的疗效分析

发布时间：2018-02-24 10:48

本文关键词： 腹腔镜袖状胃切除术肥胖症 2型糖尿病疗效分析　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨腹腔镜袖状切除术(laparoscopic sleeve gastrectomy,LSG)治疗肥胖症合并2型糖尿病(type 2 diabetes mellitus,T2DM)的手术安全性及治疗效果。方法:选取2013年4月~2015年5月在山西医科大学附属大医院行LSG的12例肥胖症合并T2DM的患者为研究对象。术后随访为12个月,比较患者手术前后体重、体重指数(BMI)、多余体重减少率(the percentage of excess weight loss,EWL%)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、空腹C肽(fasting C-peptide,FCP)、糖化血红蛋白(hemoglobin A1C,HbA1C)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、甘油三脂(triglyceride,TG)、总胆固醇(total cholesterol,TC),低密度脂蛋白(low-density lipoprotein,LDL)、高密度脂蛋白(high-density lipoprotein,HDL)、尿酸、收缩压及舒张压等相关代谢指标的变化情况。结果:12例患者手术均顺利完成,无中转开腹,术中无大量出血,术后未出现胃漏、胃出血、胃食管反流等严重并发症。术后随访时间分别为1、3、6、12个月,术后各时间点患者的体重、BMI、FPG等均低于术前(P0.05),EWL%呈上升趋势(P0.05);其他相关代谢性指标,如FINS、FCP、HbA1C、HOMA-IR、TG、TC、LDL、HDL、尿酸、收缩压及舒张压等较术前明显改善;部分患者随访至术后12个月发现空腹血糖及体重下降趋势明显减缓,逐渐进入平台期。结论:LSG减肥降糖效果确切,安全性可控,短期疗效满意,因病例数较少及随访时间较短,中远期疗效仍待进一步研究。
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with type 2 diabetes mellitus type 2 diabetes mellitusus T2DM.Methods: from April 2013 to May 2015, we conducted the operation at the affiliated Hospital of Shanxi Medical University. Twelve patients with obesity associated with T2DM in LSG were studied. The weight of patients before and after operation was compared, Body mass index (BMI), excess weight loss rate (percentage of excess weight loss), fasting plasma glucose (FPG), fasting insulin fasting (FINSN), fasting C-peptide (FCP), glycosylated hemoglobin A1CHbA1CU, insulin resistance index (IRI), homeostatic model assessment of insulin resistance (HOMA-IRN), triglyceride triglyceride (TGN), total cholesterol cholesterol (TC), total cholesterol cholesterol (TC), hemoglobin A1CbA1C, insulin resistance index (IREI), homeostatic model assessment of insulin resistance (HOMA-IRM), triglyceride triglyceride (TGN), total cholesterol cholesterol (TC), total cholesterol cholesterol (TC). Low density lipoprotein, low density lipoprotein, high density lipoprotein, high density lipoprotein, uric acid, Results all the 12 cases of operation were successfully completed, no conversion to laparotomy, no massive bleeding during operation, no gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, and no postoperative gastric bleeding. Severe complications, such as gastroesophageal reflux, were followed up for 6 and 12 months, respectively. The body weight of patients with BMI-FPG was significantly lower than that of preoperation (P0.05 / EWL%, P 0.05%). Other related metabolic indexes, such as FINSUN FCPHbA1CHOMA-IRTGG TGGN LDLL, uric acid, uric acid, et al, were found to be higher than those before operation (P < 0.05), and other related metabolic indexes, such as FINSF-FCPHbA1CHOMA-IRT, TGGN, LDLL, uric acid, uric acid, etc. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly improved than those before operation, and some patients were followed up to 12 months after operation to find that the trend of fasting blood glucose and body weight decreased significantly, and gradually entered the plateau stage. The short-term curative effect is satisfactory, because the number of cases is small and the follow-up time is short, the medium-long-term effect still needs further study.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R589.2;R656.6

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