[1]韩建立 赵浩亮 郗光霞 张晋 李小龙.腹腔镜袖状胃切除术在治疗肥胖症中的应用价值[J].中华肥胖与代谢病电子杂志,2017,(01):25-28.[doi:10.3877/cma.j.issn.2095-9605.2017.01.005]
 Han Jianli,Zhao Haoliang,Xi Guangxia,et al.Application value of laparoscopic sleeve gastrectomy in treating obesity[J].Chinese Journal of Obesity and Metabolic Disease (Electronic Edition),2017,(01):25-28.[doi:10.3877/cma.j.issn.2095-9605.2017.01.005]
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腹腔镜袖状胃切除术在治疗肥胖症中的 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:
期数:
2017年01期
页码:
25-28
栏目:
临床研究
出版日期:
2017-02-28

文章信息/Info

Title:
Application value of laparoscopic sleeve gastrectomy in treating obesity
作者:
韩建立 1 赵浩亮 1 郗光霞 2 张晋 1 李小龙 1
030001 太原,山西大医院普外科 1 ,内分泌科 2
Author(s):
Han Jianli1 Zhao Haoliang1 Xi Guangxia2 Zhang Jin1Li Xiaolong 1.
1 Department of General Surgery, Shanxi Dayi Hospital of Shanxi Medical University, Taiyuan 030001, China; 2 Department of Endocrinology, Shanxi Dayi Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
腹腔镜袖状胃切除术 肥胖症 肥胖相关代谢性疾病
Keywords:
Laparoscopic sleeve gastrectomy Obesity Obesity-related metabolic diseases
DOI:
10.3877/cma.j.issn.2095-9605.2017.01.005
摘要:
目的 探讨腹腔镜袖状胃切除术(LSG)在治疗肥胖症中的应用价值。方法 回顾性分 析2013年2月至2015年2月在山西大医院接受LSG治疗的10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5例,女5例;年龄(40±13)岁;体质指数(BMI)(42±8)kg/m 2 。 记录术前和术后1、6、12、18个月患者的体质量、BMI、多余体质量减少百分比(EWL%)、血压值、空腹血 糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C) 水平。手术前后临床指标的比较采用配对t检验。结果 术后1个月,LSG患者的BMI为(40±6)kg/m 2 ,明 显低于术前的(42±8)kg/m 2 (t=11.173,P<0.05);5例术前合并有2型糖尿病的LSG患者的FPG和HbA1c分 别为(8.4±1.2)mmol/L和(6.7±0.5)%,明显低于术前的(10.1±1.5)mmol/L和(7.8±0.6)%(t=7.611、 15.241,P<0.05);4例术前合并有高胰岛素血症的LSG患者的空腹胰岛素水平为(21.1±2.3)U/L,明显 低于术前的(26.4±2.3)U/L(t=6.355,P<0.05);8例术前合并有高血压病的LSG患者的收缩压和舒张压 分别为(140±12)和(92±6)mmHg,明显低于术前的(155±16)和(99±9)mmHg (t=7.933、4.931,P<0.05); 之后,上述指标均继续保持下降趋势。结论 LSG治疗肥胖症短中期疗效确切,相关代谢性疾病的改善 效果良好,但远期效果和复发情况仍有待于进一步研究以明确。
Abstract:
Objective To investigate the clinical application value of laparoscopic sleeve gastrectomy (LSG) in treating obesity. Methods Clinical data of 10 obese patients undergoing LSG in Shanxi Dayi Hospital of Shanxi Medical University from February 2013 to February 2015 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 10 patients, 5 were males and 5 were females with an average age of (40±13) years old and an average BMI of (42±8) kg/m 2 . Body weight, BMI, percentage of excess body weight loss (EWL%), blood pressure, fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), fasting insulin, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) of these patients were collected before and 1, 6, 12, 18 months after operation. Comparisons of the data before and after operation were conducted using t test. Results One month after operation, the average BMI of the LSG patients was (40±6) kg/m 2 , which was significantly lower than (42±8) kg/m 2 before operation (t=11.173, P<0.05); the FPG and HbA1c of the 5 patients with preoperative type 2 diabetes mellitus were (8.4±1.2) mmol/L and (6.7±0.5)% respectively, which were significantly lower than (10.1±1.5) mmol/L and (7.8±0.6)% before operation (t=7.611, 15.241, P<0.05); the fasting insulin of the 4 patients with preoperative hyperinsulinemia was (21.1±2.3) U/L, which was significantly lower than (26.4±2.3) U/L before operation (t=6.355, P<0.05); the systolic and diastolic pressure of the 8 patients with preoperative hypertension were (140±12) and (92±6) mmHg respectively, which were lower than (155±16) and (99±9) mmHg before operation (t=7.933, 4.931, P<0.05); and after that, all the above indexes kept the downtrend. Conclusion LSG has a reliable short- term effect on obesity, with a good improvement of obesity-related metabolic diseases, but its long-term effect and recurrence remain to be further investigated.

参考文献/References:

[1] 郑成竹 , 张鼎宇 . 2 型糖尿病的外科治疗 [J]. 中华胃肠外科杂志 , 2009, 12(6):545-548.
[2] Hady HR, Dadan J, Luba M. The influence of laparoscopic sleeve gastrectomy on metabolic syndrome parameters in obese patients in own material[J]. Obes Surg, 2012, 22(1):13-22.
[3] 杨雁灵 , 窦科峰 , 周景师 , 等 . 胃袖状切除术的规范化实施 [J]. 中 国实用杂志 , 2014,34(11):1109-1110.
[4] 许博 , 姚琪远 . 腹腔镜袖状胃切除术在减重与代谢外科中应用的 评价 [J]. 中华胃肠外科杂志 , 2013, 16(10):1017-1020.
[5] Lee WJ, Chen CY, Chong K, et al. Changes in postprandial gut hormones after Metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy[J]. SurgObes Relat Dis, 2011, 7(6):683-690.
[6] Lakdawala MA, Bhasker A, Mulchandani D, et a1. Comparison between the results of sleeve gastrectomy and laparoscopic Roux- en-Y gastric bypass in the Indian population: a retrospective 1 year study[J]. Obes Surg, 2010, 20(1):1-6.
[7] Kueper MA, Kralller KM, Kirschniak A, et a1. Laparoscopic sleeve gastrectomy: standardized technique of a potential stand—alone bariatric procedure in morbidly obese patients[J]. World J Stag, 2008, 32(7):1462-1465.
[8] 朱江帆 . 减肥手术治疗代谢综合症的机制:胃中心假说 [J]. 中华 肥胖与代谢病电子杂志,2015, 1(1):39-40.
[9] 林懋全 , 王存川 , 杨景哥 , 等 . LRYGB 和 LSG 治疗 T2DMGLP-1 和 Ghrelin 水平的影响 [J]. 中华肥胖与代谢病电子杂志 , 2015, 1(2):80-84.
[10] Leonetti F, Capoccia D, Coccia F, et al. Obesity, type 2 diabetes mellitus, and other comorbidities: a prospective cohort study of laparoscopic sleeve gastrectomy vs medical treatment[J]. Arch Surg, 2012, 147(8):694-700.
[11] Chopra A, Chao E, Etkin Y, et al. Laparoscopic sleeve gastrectomy for obesity:can it be considered a definitive procedure?[J]. Surg Endosc, 2012, 26(3):831-837.

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备注/Memo

备注/Memo:

通讯作者:韩建立,Email:1292225922@qq.com
更新日期/Last Update: 2017-02-28