河北医学
河北醫學
하북의학
HEBEI MEDICINE
2014年
8期
1307-1310
,共4页
2型糖尿病%胃旁路术%腹腔镜%肥胖
2型糖尿病%胃徬路術%腹腔鏡%肥胖
2형당뇨병%위방로술%복강경%비반
Type-2 diabetes mellitus%Gastric bypass%Laparoscopy%Obese
目的:探讨腹腔镜Roux-en-Y胃旁路手术( LRYGB)治疗肥胖型和非肥胖型2型糖尿病( T2DM)的疗效和疗效差异。方法:回顾性分析我院2010年1月至2012年12月收治的72例行LRYGB的T2DM的临床资料,其中肥胖组42例,非肥胖组30例。结果:两组患者术中均无损伤大血管、肠管等严重并发症,无中转开腹病例。两组患者手术出血量、术后初次下床活动时间、术后排气时间、术后并发症发生率无明显统计学差异(均P>0.05);肥胖组手术时间高于非肥胖组( P=0.039)。术前肥胖组与非肥胖组空腹血糖(FBG)、餐后2h血糖(2h PBG)、糖化血红蛋白(HbA1c)、空腹C肽、胰岛素抵抗指数(Homa-IR)、胰岛功能指数(Homa-β)比较无明显统计学差异(均P>0.05)。术后两组患者FBG、2h PBG、HbA1c、Homa-IR 较术前均有所下降,空腹C 肽、Homa-β均有所升高(均P<0.05)。肥胖组术后FBG、2h PBG、空腹C肽、Homa-IR、Homa-β与非肥胖组无明显统计学差异(均P>0.05);HbA1c较非肥胖组要低( P<0.05)。肥胖组临床有效率为92.86%,高于非肥胖组83.33%,但差异不具有统计学意义( X2=1.607,P=0.205)。结论:腹腔镜Roux-en-Y胃旁路手术治疗肥胖型和非肥胖型2型糖尿病短期疗效均较好,长期疗效需待随访。
目的:探討腹腔鏡Roux-en-Y胃徬路手術( LRYGB)治療肥胖型和非肥胖型2型糖尿病( T2DM)的療效和療效差異。方法:迴顧性分析我院2010年1月至2012年12月收治的72例行LRYGB的T2DM的臨床資料,其中肥胖組42例,非肥胖組30例。結果:兩組患者術中均無損傷大血管、腸管等嚴重併髮癥,無中轉開腹病例。兩組患者手術齣血量、術後初次下床活動時間、術後排氣時間、術後併髮癥髮生率無明顯統計學差異(均P>0.05);肥胖組手術時間高于非肥胖組( P=0.039)。術前肥胖組與非肥胖組空腹血糖(FBG)、餐後2h血糖(2h PBG)、糖化血紅蛋白(HbA1c)、空腹C肽、胰島素牴抗指數(Homa-IR)、胰島功能指數(Homa-β)比較無明顯統計學差異(均P>0.05)。術後兩組患者FBG、2h PBG、HbA1c、Homa-IR 較術前均有所下降,空腹C 肽、Homa-β均有所升高(均P<0.05)。肥胖組術後FBG、2h PBG、空腹C肽、Homa-IR、Homa-β與非肥胖組無明顯統計學差異(均P>0.05);HbA1c較非肥胖組要低( P<0.05)。肥胖組臨床有效率為92.86%,高于非肥胖組83.33%,但差異不具有統計學意義( X2=1.607,P=0.205)。結論:腹腔鏡Roux-en-Y胃徬路手術治療肥胖型和非肥胖型2型糖尿病短期療效均較好,長期療效需待隨訪。
목적:탐토복강경Roux-en-Y위방로수술( LRYGB)치료비반형화비비반형2형당뇨병( T2DM)적료효화료효차이。방법:회고성분석아원2010년1월지2012년12월수치적72례행LRYGB적T2DM적림상자료,기중비반조42례,비비반조30례。결과:량조환자술중균무손상대혈관、장관등엄중병발증,무중전개복병례。량조환자수술출혈량、술후초차하상활동시간、술후배기시간、술후병발증발생솔무명현통계학차이(균P>0.05);비반조수술시간고우비비반조( P=0.039)。술전비반조여비비반조공복혈당(FBG)、찬후2h혈당(2h PBG)、당화혈홍단백(HbA1c)、공복C태、이도소저항지수(Homa-IR)、이도공능지수(Homa-β)비교무명현통계학차이(균P>0.05)。술후량조환자FBG、2h PBG、HbA1c、Homa-IR 교술전균유소하강,공복C 태、Homa-β균유소승고(균P<0.05)。비반조술후FBG、2h PBG、공복C태、Homa-IR、Homa-β여비비반조무명현통계학차이(균P>0.05);HbA1c교비비반조요저( P<0.05)。비반조림상유효솔위92.86%,고우비비반조83.33%,단차이불구유통계학의의( X2=1.607,P=0.205)。결론:복강경Roux-en-Y위방로수술치료비반형화비비반형2형당뇨병단기료효균교호,장기료효수대수방。
Objective:To explore the efficacy of laparoscopic Roux-en-Y gastric bypass ( LRYGB) for patients with obese and non-obese type-2 diabetes mellitus ( T2DM) , and compare the difference .Method:Clinical data of 72 patients with T2DM undergoing LRYGB from January 2010 to December 2012 were ana-lyzed retrospectively.They were divided into the obese group (n=42) and the non-obese group (n=30). Result:All of the patients underwent the operation without serious intraoperative complications , and no pa-tient was converted to open surgery .The blood loss , time to resume early activity , postoperative exhaust time, and the incidence of complications were compared between two groups (All P>0.05).The operative time in the obese group was more than that in the non-obese time ( P=0.039) .The differences of the preop-erative level of FBG, 2hPBG, HbA1c, the peptide C, Homa-IR and Homa-βbetween the two groups were no significant (All P>0.05), and the postoperative result was similar (All P>0.05) except the HbA1c (P<0.05).Ther's no difference for the effective rate between the two groups (92.86%vs.83.33%) (X2=1. 607, P=0.205).Conclusion:LRYGB for obese and non-obese T2DM can get a good efficacy in the short term, but the long-term efficacy need to be further observed .