[1]伍方旭 陈茜 陈伟 张晶晶 周智广 刘威.腹腔镜Roux-en-Y胃旁路术在改善肥胖症患者生活质量中的应用价值[J].中华肥胖与代谢病电子杂志,2016,2(02):90-95.[doi:10.3877//cma.j.issn.2095-9605.2016.02.007]
 Wu Fangxu,Chen Xi,Chen Wei,et al.Application value of laparoscopic Roux-en-Y gastric bypass in improving the quality of life for obesepatients[J].Chinese Journal of Obesity and Metabolic Disease (Electronic Edition),2016,2(02):90-95.[doi:10.3877//cma.j.issn.2095-9605.2016.02.007]
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腹腔镜Roux-en-Y胃旁路术在改善肥胖症患者生活质量中的应用价值()
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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02期
页码:
90-95
栏目:
临床研究
出版日期:
2016-06-29

文章信息/Info

Title:
Application value of laparoscopic Roux-en-Y gastric bypass in improving the quality of life for obesepatients
作者:
伍方旭1 陈茜2 陈伟1 张晶晶2 周智广2 刘威1
410000 长沙,中南大学湘雅二医院微创外科1,内分泌科2
Author(s):
Wu Fangxu1 Chen Xi2 Chen Wei1 Zhang Jingjing2 Zhou Zhiguang2 Liu Wei1
1Department ofMinimal Invasive Surgery, the Second Xiangya Hospital of Central South University, Changsha 410000,China; 2Department of Endocrine, the Second Xiangya Hospital of Central South University, Changsha410000, ChinaCorresponding author: Liu Wei, Zhou Zhiguang, Email: liuweixy@outlook.com
关键词:
肥胖症 腹腔镜Roux-en-Y胃旁路术 生活质量
Keywords:
Obesity Laparoscopic Roux-en-Y gastric bypass Quality of life
DOI:
10.3877//cma.j.issn.2095-9605.2016.02.007
摘要:
目的 探讨腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass, LRYGB)在改善肥胖症患者生活质量中的应用价值,分析该术式与LRYGB前后生活质量相关的因素。 方法 回顾性分析2013年2月至2014年2月在中南大学湘雅二医院接受LRYGB治疗的20例肥胖症患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。其中男10例,女10例;平均年龄(43±3)岁。术前和术后测量患者的体重,计算体质指数(body mass index, BMI)、多余体重减少百分比(percentage of excessbody weight loss, EWL%),检测空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(glycosylatedhemoglobin A1c, HbA1c),观察合并症的改善情况;采用Moorhead-Ardelt Quality of Life Questionnaire Ⅱ(MAⅡ)表对患者的生活质量进行评估。手术前后临床指标的比较采用配对t检验,手术前后生活质量等级的比较采用Spearman秩相关分析,生活质量总分与BMI、 FPG、 HbA1c相关性的分析采用Pearson相关分析。 结果 20例患者均成功完成LRYGB治疗,1例患者术后出现吻合口漏,1例患者术后发生肺炎,均经保守治疗后痊愈。术后12个月,患者的BMI为(27.7±0.9)kg/m2,明显低于术前的(37.5±1.8)kg/m2( t=9.47,P<0.05);患者的FPG为(5.24±0.11)mmol/L,明显低于术前的(7.91±0.60)mmol/L ( t=4.52,P<0.05);患者的HbA1c是(5.60±0.11)%,明显低于术前的(8.65±0.56)% ( t=5.53,P<0.05);患者的生活质量总评分为(1.33±0.16)分,明显高于术前的(-0.07±0.24)分( t=-5.09,P<0.05)。患者术前生活质量总评分与BMI呈负的直线相关关系( r=-0.45,P<0.05),术后生活质量总评分与FPG呈负的直线相关关系( r=-0.54,P<0.05)。 结论 LRYGB治疗肥胖症和2型糖尿病安全有效,可以显著改善患者术后的生活质量, BMI和血糖水平与手术前后的生活质量存在相关关系,故需加强手术对两者治疗效果的预测和评估。
Abstract:
Objective To investigate the application value of laparoscopic Roux-en-Y gastric bypass(LRYGB) in improving the quality of life for obese patients and to analyze the factors related to the qualityof life before and after LRYGB. Methods Clinical data of 20 obese patients undergoing LRYGB in theSecond Xiangya Hospital of Central South University from February 2013 to February 2014 were analyzedretrospectively. The informed consents were obtained from all of the patients and the local ethical committeeapproval had been received. Among the 20 patients, 10 were males and 10 were females with an averageage of (43±3) years old. The data of weight, body mass index (BMI), percentage of excess body weight loss(EWL%), fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) were measured pre-and post-operatively, the improvement of complications was also recorded. The Moorhead-Ardelt Qualityof Life Questionnaire Ⅱ(MAⅡ) was used to evaluate the quality of life. The comparisons of clinical indexesbefore and after operation were conducted using paired t test, the comparison of the rank of quality of lifewas conducted using Spearman rank correlation analysis, and the correlation analysis between quality oflife and BMI, FPG and HbA1c was conducted using Pearson correlation analysis. Results Twenty patientsreceived LRYGB successfully. One patient with anastomotic leakage and another one with pneumonia afteroperation were cured with conservative treatments. At 12 months after operation, BMI was (27.7±0.9) kg/m2,which was significantly lower than (37.5±1.8) kg/m2 before operation (t=9.47, P<0.05); FPG was (5.24±0.11) mmol/L,significantly lower than (7.91±0.60) mmol/L before operation (t=4.52, P<0.05); HbA1c was (5.60±0.11)%,significantly lower than (8.65±0.56)% before operation (t=5.53, P<0.05); and the total score of life qualitywas 1.33±0.16, which was also significantly higher than -0.07±0.24 before operation (t=-5.09, P<0.05).The correlation analysis showed that BMI was negatively correlated with the total score of life qualitypreoperatively (r=-0.45, P<0.05), while FPG was negatively correlated with the total score of life qualitypostoperatively (r=-0.54,P<0.05). Conclusions LRYGB is a safe and effective therapeutic method forobesity and type 2 diabetes, which can improve patients’ quality of life postoperatively. There are relevantrelationships between BMI, FPG and pre- and post-operative quality of life, suggesting that BMI and FPGshould be predicted and evaluated as outcome analysis of LRYGB.

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备注/Memo

备注/Memo:
基金项目:湖南省科技厅一般项目(2012FJ6022)
通讯作者:刘威,周智广,Email:liuweixy@outlook.com
更新日期/Last Update: 2016-05-30