[1]陈宏 雒洪志 周小雕 余元龙 梁义 王存川.腹腔镜Roux-en-Y 胃旁路术在治疗肥胖型2 型糖尿病中的应用价值[J].中华肥胖与代谢病电子杂志,2016,2(01):26-29.[doi:10.3877//cma.j.issn.2095-9605.2016.01.006]
 Chen Hong,Luo Hongzhi,Zhou Xiaodiao,et al.Application value of laparoscopic Roux-en-Y gastric bypass in treating obese type 2 diabetes mellitus[J].Chinese Journal of Obesity and Metabolic Disease (Electronic Edition),2016,2(01):26-29.[doi:10.3877//cma.j.issn.2095-9605.2016.01.006]
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腹腔镜Roux-en-Y 胃旁路术在治疗肥胖型2 型糖尿病中的应用价值()
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《中华肥胖与代谢病电子杂志》[ISSN:2095-9605/CN:11-9362]

卷:
第2卷
期数:
2016年01期
页码:
26-29
栏目:
临床研究
出版日期:
2016-03-30

文章信息/Info

Title:
Application value of laparoscopic Roux-en-Y gastric bypass in treating obese type 2 diabetes mellitus
作者:
陈宏1 雒洪志1 周小雕1 余元龙1 梁义1 王存川2
528400 广东中山,中山市人民医院普外三科1;510630 广州,暨南大学附属第一医院普外科2
Author(s):
Chen Hong1 Luo Hongzhi1 Zhou Xiaodiao1 Yu Yuanlong1 Liang Yi1 Wang Cunchuan2. 1
1Department three ofGeneral Surgery, the People’s Hospital of Zhongshan, Zhongshan 528400, China; 2Department of GeneralSurgery, the first Affiliated Hospital of Jinan University, Guangzhou 510630, ChinaCorresponding author: Chen Hong, Email: cenhong228@sohu.com
关键词:
腹腔镜Roux-en-Y胃旁路术 肥胖症 糖尿病2型
Keywords:
Laparoscopic Roux-en-Y gastric bypass Obesity Diabetes mellitus type 2
DOI:
10.3877//cma.j.issn.2095-9605.2016.01.006
摘要:
目的 探讨腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)在治疗肥胖型2型糖尿病中的临床应用价值。方法 回顾性分析2010年8月至2014年12月在中山市人民医院接受LRYGB治疗的42例肥胖型2型糖尿病患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。其中男28例,女14例;平均年龄(45±10)岁。术前和术后1周、1个月、3个月对所有患者的体质指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2-hour postprandialblood glucose,2hPG)、血清C肽、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)和胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)进行检测。手术前后临床指标的比较采用t检验。结果 LRYGB后3个月,患者的平均BMI为(23.7±1.1)kg/m2,明显低于术前的(29.1±3.1)kg/m2(t=2.835,P<0.05);平均FPG水平为(6.1±0.5)mmol/L,明显低于术前的(12.5±3.9)mmol/L(t=3.861,P<0.05);平均HbA1c水平为(5.3±0.8)%,明显低于术前的(11.2±2.1)%(t=4.062,P<0.05);平均HOMA-IR为4.3±0.5,明显低于术前的7.2±0.7(t=3.575,P<0.05)。2型糖尿病的治疗有效率为100%(42/42),治愈率为90%(38/42)。结论 LRYGB治疗肥胖型2型糖尿病近期疗效显著,远期疗效仍有待于进一步观察。
Abstract:
Objective To investigate the clinical application value of laparoscopic Roux-en-Ygastric bypass (LRYGB) in treating obese type 2 diabetes mellitus. Methods Clinical data of 42 patientswith obese type 2 diabetes mellitus undergoing LRYGB in the People’s Hospital of Zhongshan fromAugust 2010 to December 2014 were retrospectively studied. The informed consents of all patients wereobtained and the local ethical committee approval had been received. Among the 42 patients, 28 were malesand 14 were females with an average age of (45±10) years old. Body mass index (BMI), fasting plasmaglucose (FPG), 2-hour postprandial blood glucose (2hPG), C peptide and glycosylated hemoglobin A1c(HbA1c) and homeostatic mode assessment of insulin resistance (HOMA-IR) were tested before and 1 week,1 month, 3 months after operation. Clinical data before and after operation were compared using t test.Results At 3 months after operation, the average BMI was (23.7±1.1) kg/m2, which was significantlylower than (29.1±3.1) kg/m2 before operation(t=2.835, P<0.05); the average FPG was (6.1±0.5) mmol/L,which was significantly lower than (12.5±3.9) mmol/L before operation (t=3.861, P<0.05); the averageHbA1c was (5.3±0.8)%, which was significantly lower than (11.2±2.1)% before operation(t=4.062, P<0.05);the average HOMA-IR was 4.3±0.5, also significantly lower than 7.2±0.7 (t=3.575, P<0.05). The effective ratio of the treatment of type 2 diabetes mellitus was 100% (42/42), and the cure rate was 90% (38/42).Conclusions LRYGB has an exact short-term effect on obese type 2 diabetes mellitus, but the long-termeffect remains to be observed further.

参考文献/References:

[1] Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide2011[J]. Obes Surg, 2013, 23(4):427-436.
[2] 雒洪志, 陈宏, 余元龙, 等. 腹腔镜下Roux-en-Y 胃空肠转流术治疗肥胖型2 型糖尿病14 例[J]. 中华普通外科学文献(电子版),2012, 6(6):503-506。
[3] American Diabetes Association. Standards of medical care indiabetes--2010[J].Diabetes Care, 2010, 33(suppl 1):S11-S61.
[4] 蔡逊, 马丹丹, 叶家欣, 等. 腹腔镜袖状胃切除术与胃旁路术治疗肥胖症的临床疗效观察[J]. 腹腔镜外科杂志, 2015, 20(7):516-520.
[5] 黄致锟. 腹腔镜下Roux-en-Y 胃旁路术在非病态肥胖患者2型糖尿病治疗中的应用价值[J]. 中国医学科学院学报, 2011,33(3):272-276.
[6] 杨景哥, 王存川, 黄璟, 等. 腹腔镜Roux-en-Y 胃旁路术治疗2 型糖尿病[J]. 南方医科大学学报, 2010, 30(6):1373-1375. 
[7] He B, Chen L, Yu C, et al. Roux-en-Y gastric bypass increaseshepatic and peripheral insulin sensitivity in rats with type 2 diabetesmellitus[J]. Surg Obes Relat Dis, 2014, 10(3):485-493.

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备注/Memo

备注/Memo:

通讯作者:陈宏,Email:cenhong228@sohu.com
更新日期/Last Update: 2016-03-30