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纸质出版:2014
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陈满,汪志红,张力,张军,李启富,刘智平,唐瑶,陈书梅,刘秀容,杨淑敏.腹腔镜下Roux-en-Y胃旁路术治疗肥胖2型糖尿病患者的近期疗效分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(07):691-695.
Chen Man,Wang Zhihong,Zhang Li,Zhang Jun,Li Qifu,Liu Zhiping,Tang Yao,Chen Shumei,Liu Xiurong,Yang Shumin.Short-term efficacy of laparoscopic Roux-en-Y gastric bypass in obese patients with type 2 diabetes[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(07):691-695.
陈满,汪志红,张力,张军,李启富,刘智平,唐瑶,陈书梅,刘秀容,杨淑敏.腹腔镜下Roux-en-Y胃旁路术治疗肥胖2型糖尿病患者的近期疗效分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(07):691-695. DOI:
Chen Man,Wang Zhihong,Zhang Li,Zhang Jun,Li Qifu,Liu Zhiping,Tang Yao,Chen Shumei,Liu Xiurong,Yang Shumin.Short-term efficacy of laparoscopic Roux-en-Y gastric bypass in obese patients with type 2 diabetes[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(07):691-695. DOI:
目的 观察腹腔镜下Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)在肥胖2型糖尿病患者治疗中的近期临床疗效和安全性。 方法 纳入我院近3年来行LRYGB手术的肥胖2型糖尿病患者12例,其中男性4例,女性8例;年龄(43.8±10.6)岁;糖尿病病程(8.3±3.9)年;体质量指数(31.3±5.6)kg/m
2
;空腹血糖(9.4±1.9)mmol/L;HbA1c(8.4±1.6)%。患者均完成术后12个月的随访。以术后停用所有降糖治疗,空腹血糖<7.0 mmol/L和HbA1c<6.5%者,判定为2型糖尿病临床完全缓解。观察手术后患者体质量、血糖、血脂、血压、用药用量等变化以及术后相关并发症情况。 结果 LRYGB术后12个月患者显著降低体质量(20.4±9.7)kg,显著缩小腰围(23.4±14.1)cm,同时降低HbA1c(2.1±1.7)%。2型糖尿病临床完全缓解7例(58.3%),临床部分缓解5例(41.7%)。合并有高血压病、血脂异常的患者术后均停用所有降压、降脂药物。与临床部分缓解组相比,临床完全缓解组的糖尿病病程更短[(4.6±3.3)年vs (10.6±3.7)年,
P
0.05
]
。12例患者无1例死亡。患者术后近期并发症发生1例(8.3%),远期并发症发生1例(8.3%)。 结论 LRYGB治疗肥胖2型糖尿病患者的近期临床疗效满意,能有效控制患者的血糖、血脂及血压。
Objective To evaluate the short-term clinical efficacy and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) in obese patients with type 2 diabetes mellitus (T2DM). Methods Twelve obese T2DM patients undergoing LRYGB from May 2010 to August 2013 were recruited in this study. They were 4 males and 8 females
with a mean age of 43.8±10.6 years
a mean duration of T2DM for
8.3±3.9 years
a body mass index of 31.3±5.6 kg/m
2
fasting plasma glucose of 9.4±1.9 mmol/L
and HbA1c of (8.4±1.6)% before surgery. The cohort was followed up for a period of 12 months. Main outcome measures were the rate of diabetes remission (complete remission of diabetes was defined as a fasting plasma glucose level of less than 7.0 mmol/L and HbA1c level less than 6.5% without active pharmacologic therapy). Data on demographics
lipid profiles
blood pressure
levels glucose and HbA1c
medication
and remission were prospectively collected and analyzed with post-operative data. Results In 12 months after LRYGB
there were significant decreases in body weight (20.4±9.7 kg)
waist circumference (23.4±14.1 cm)
and in HbA1c [(2.1±1.7)%
]
. There were 7 patients (58.3%) having T2DM complete remission
and 5 (41.7%) with partial remission. For the patients complicated with hypertension and/or dyslipidemia
their antihypertensive agents and lipid-lowering drugs were stopped to use after surgery. The group achieving T2DM complete remission had a shorter duration of diabetes compared with the partial remission group(4.6±3.3 years vs 10.6±3.7 years,
P
0.05). There was no mortality
and one (8.3%) patient experienced early complications and another one (8.3%) with the long-term complications. Conclusion LRYGB has satisfying short-term outcomes in the treatment of obese T2DM
with well control on blood glucose
lipids and bood pressure.
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