腹腔镜袖状胃切除术治疗病态性肥胖合并2型糖尿病近期疗效分析

目的:探讨行腹腔镜袖状胃切除术治疗合并2型糖尿病(type 2 diabetes mellitus,T2DM)肥胖症病人的效果。方法:回顾性分析上海长征医院普外三科2008年7月至2011年12月行腹腔镜袖状胃切除术治疗合并T2DM的肥胖症8例病人的术前资料和术后12个月的随访资料。结果:所有病人均在腹腔镜下完成手术,无中转开腹。术中术后均无严重并发症发生。在术后12个月的随访过程中,病人体重、体重指数均呈下降趋势,与术前相比,术后1月开始差异即有统计学意义(P0.01)。术后12个月T2DM临床完全缓解4例(50%),临床部分缓解4例(50%)。所有病人术后糖化血红蛋白、空腹血糖均呈下降趋势,从术后1个月开始,糖化血红蛋白与术前相比差异有统计学意义(P0.01),术后3个月复查5例(62.5%)已恢复正常水平;空腹血糖自术后1月开始与术前相比差异即有统计学意义(P0.01)。结论:腹腔镜袖状胃切除术是一种安全、有效的治疗肥胖症合并T2DM的手术方式。

Short-termEffect of Laparoscopic Sleeve Gastrectomy for 8 Obesity Patients with Type 2 Diabetes Mellitus*

Objective： To evaluate the short-term effect of laparoscopic sleeve gastrectomy （LSG） on obesity patients with type 2 diabetes mellitus（T2DM）. Methods： 8 obesity patients with T2DM underwent LSG surgery from the 3rd department of general surgery of Shanghai Changzheng hospital during July 2008 to December 2011 were included, their clinical data before and after surgery were analyzed retrospectively. Results： All the performations were completed under laparoscopy. There were no conversion or operative complications. There were no serious post-procedure complications. During 12 months of follow-up, all the patients＇weight and body ma- ss index （BMI） was decreased, compared with those before operation （P 〈 0.01）. 12 months after procedure, 4 （50%）T2DM cases got complete remission, the other 4 （50%）cases got partial remission. The level of hemoglobin Ale （HbAlc） and fasting plasma glucose （FPG） was significantly decreased after procedure （P〈0.01） since 1 month after procedure, and 3 months later, the HbAlc level of 5 （62.5%） patients had come back to the normal range. Conclusions： LSG may result in satisfactory weight loss and clinical remission of T2DM with few complications. A longer follow-up period is needed.